1. Investigation of the Accuracy of 18 Marketed Blood Glucose Monitors
- Author
-
Wendy C. Bevier, Boris Kovatchev, Timothy S. Bailey, Michael Kohn, Mark P. Christiansen, Ronald L. Brazg, David Kerr, David C. Klonoff, Joan Lee Parkes, and James H. Nichols
- Subjects
Adult ,Blood Glucose ,Male ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Coefficient of variation ,030209 endocrinology & metabolism ,Reference laboratory ,Food and drug administration ,Prediabetic State ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Double-Blind Method ,Reference Values ,Statistics ,Internal Medicine ,Diabetes Mellitus ,Medicine ,Humans ,030212 general & internal medicine ,Aged ,Advanced and Specialized Nursing ,Aged, 80 and over ,business.industry ,United States Food and Drug Administration ,Blood Glucose Self-Monitoring ,Limits of agreement ,Commerce ,Reproducibility of Results ,Blood glucose monitors ,Middle Aged ,United States ,Multicenter study ,Equipment and Supplies ,Hematocrit ,Patient Compliance ,Female ,business ,Clinical risk factor ,Clearance - Abstract
OBJECTIVE Cleared blood glucose monitors (BGMs) for personal use may not always deliver levels of accuracy currently specified by international and U.S. regulatory bodies. This study’s objective was to assess the accuracy of 18 such systems cleared by the U.S. Food and Drug Administration representing approximately 90% of commercially available systems used from 2013 to 2015. RESEARCH DESIGN AND METHODS A total of 1,035 subjects were recruited to have a capillary blood glucose (BG) level measured on six different systems and a reference capillary sample prepared for plasma testing at a reference laboratory. Products were obtained from consumer outlets and tested in three triple-blinded studies. Each of the three participating clinical sites tested a different set of six systems for each of the three studies in a round-robin. In each study, on average, a BGM was tested on 115 subjects. A compliant BG result was defined as within 15% of a reference plasma value (for BG ≥100 mg/dL [5.55 mmol/L]) or within 15 mg/dL (0.83 mmol/L) (for BG 20%; modified Bland-Altman analysis including average bias, coefficient of variation, and 95% limits of agreement; and proportion of readings with no clinical risk as determined by the Surveillance Error Grid. RESULTS The different accuracy metrics produced almost identical BGM rankings. Six of the 18 systems met the predetermined accuracy standard in all three studies, 5 systems met it in two studies, and 3 met it in one study. Four BGMs did not meet the accuracy standard in any of the three studies. CONCLUSIONS Cleared BGMs do not always meet the level of analytical accuracy currently required for regulatory clearance. This information could assist patients, professionals, and payers in choosing products and regulators in evaluating postclearance performance.
- Published
- 2017