On 17/04/2012 22:42, Nikki Lee wrote:

[...]
> Bedside reagent test-strip
> glucose analyzers can be used if the
> test is performed carefully and the clinician is aware of the limited
> accuracy
> of these devices. (NIKKI: SO WHY DO A TEST IF IT HAS LIMITED ACCURACY?)
[...]
>
> Unfortunately, this variation is greatest
> at low glucose concentrations. There is
> no point-of-care method that is suffi-
> ciently reliable and accurate in the low
> range of blood glucose to allow it to be
> used as the sole method for screening
> for NH. (SO WHY BOTHER WITH POINT-OF-CARE METHODS?)
>

I'd hazard a guess that it's a trade-off against other factors such as 
speed, ease, and cost.  Taking venous samples is time-consuming, 
probably more distressing for baby, more costly, and the results usually 
don't come back for several hours, which could potentially be 
dangerously long if a baby is hypoglycaemic.  Point-of-care testing 
could therefore be useful as an initial screening test to pick up the 
ones who need the more detailed venous glucose sampling, and to enable 
treatment to be started pending the venous sample results if the 
point-of-care test indicates significant hypoglycaemia.  There are a lot 
of trade-offs like that in medicine - you don't usually get a perfect 
test that fulfils all possible criteria of test excellency.  ;-)


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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