Precision, stability, and interference studies of the methods were performed. Van der Maas et al11 previously demonstrated that use of an alternate ESR method affected the validity of the Disease Activity Score 28 (DAS 28). When the specimens are stored at 4°C, the ESR results did not change significantly after 24‐hr collection, but the ESR results of the samples at room temperature (25°C) decreased significantly at 6 and 24 hr. These studies confirm that systemic biases exist among automated testing devices based on aggregation or centrifugation principles as compared to sedimentation methods. A major limitation of the Westergren ESR is the need to analyze the test within 4 hours from the time of collection when stored at RT.15 The result is that many referred ESR samples in everyday practice are rejected.
ESR measurements were performed by the iSED and Ves‐Matic Cube 200 at 4, 6, 8, and 24 hr after collection.
Ves-Matic CUBE 200: is modified Westergren method for erythrocyte sedimentation rate a valid alternative to the gold standard?. Another method, photometric rheoscope, is used by the iSED analyzer, gives results in 20 sec, and there are no temperature correction settings. Although traditional Westergren method is accepted as the gold standard method for the measurement of ESR, but being time‐consuming, laborious, and having contamination risks 2 it is not preferred for routine use. Similarly other novel methods, have also been reported to overestimate the ESR compared to the reference Westergren method.10, 14, 20 Results of proficiency testing indicate differences of ~40% between Westergren and non‐Westergren‐based methods in particular at upper and lower ends of the analytical range.15 Shelat et al14 studied a pediatric population and found a correlation 0.63 with a mean bias of 3.30 mm/h (CI 1.52‐5.08) in the normal range 0‐20 mm/h with the ESR STAT PLUS (HemaTechnologies, Lebanon, NJ). Patients’ samples with low (<20 mm/hr), medium (20–80 mm/hr), and high (>80 mm/hr) levels of ESR were analyzed by 20 replicate measurements in the iSED and Ves‐Matic Cube 200. Working off-campus? Similarly, hemolysis does cause a falsely low ESR measurement in Ves‐Matic Cube 200 (P = 0.005). The tubes are directly put into the analyzers, which reduces the risk of contamination, and also is more practical for routine intense work.
Arthroscopy: The Journal of Arthroscopic & Related Surgery. Passing–Bablok regression analysis was performed. Lipemia and hemolysis were performed for interference studies.
RBC count and hematocrit levels were negatively correlated with ESR results measured by the iSED (r = −0.299, P = 0.001; r = −0.441, P < 0.001, respectively).
This prospective study included blood samples from 136 patients (87 females and 49 males) selected randomly from both inpatients and outpatients who were admitted to Ankara Numune Education and Research Hospital in June 2013. This method is based on photometric aggregometry and requires a minimum sample volume of 100ul. The iSED sedimentation method showed a poor correlation with the Westergren method (r = 0.76, P < 0.0001). We compared the iSED with the predicate modified Westergren method (StaRRsed, Mechatronics, Zwaag, the Netherlands) measured at 60 minutes.
Mahlangu et al and Vennapusa et al showed a correlation of 0.96 and 0.83 with a mean bias of 6.6 mm/h (CI 5.0‐8.1) and 7.13 mm/h, respectively, across all ranges on the Streck ESR Autoplus.10, 20 In contrast, other novel methods have been reported to underestimate the ESR, in particular at lower ESR levels.11, 13 Curvers et al13 showed a correlation of 0.83 with a mean bias of −5.7 mm/h (CI −50.8 to 39.4) on the Ves‐Matic Cube 200 (Diesse Diagnostica Senese, Siena, Italy), as compared to the Westergren method. Elise Schapkaitz, Department of Molecular Medicine and Hematology, University of Witwatersrand Medical School, Faculty of Health Sciences, Johannesburg, South Africa. Our enteral feeding pumps and administration sets are easy-to-use and cost effective. Similarly, physiological saline was added to selected ten samples in order to eliminate the effect of dilution and evaluate the net impact of lipemia and hemolysis (99 volumes of the blood, one volume physiological saline for lipemia and nine volumes of the blood, one volume physiological saline for hemolysis). The Bland‐Altman difference plot was used to assess the absolute differences, and a Deming regression analysis was used to determine the degree of correlation between the iSED and StaRRsed analyzers. The Ves‐Matic Cube 200 ESR results, when the specimens are stored at refrigerator, did not change significantly after 24‐hr collection but ESR results of room temperature samples decreased significantly at 6 and 24 hr.
Twenty samples were chosen randomly and ten of them were stored at room temperature (25°C). Lipemia and hemolysis were performed for interference studies. The increase in ESR is nonspecific for many diseases 4, but the levels of ESR are markedly elevated in polymyalgia rheumatica and temporal arteritis (often higher than 100 mm/hr), which can be specifically used for diagnose and follow‐up 1. iSED ESR measurements were stable up to 24 hours when stored at room temperature or at 4‐8°C. There was a significant positive correlation between CRP levels and ESR results measured by the iSED (r = 0.643, P < 0.001). As such hematocrit and viscosity will interfere significantly with results of this sedimentation method. We used ClinOleic® 20% solution (Eczacıbaşı, Baxter, Turkey) as lipid solution.
The ESR test, described about 70 years ago, is one of the most widely performed laboratory tests 7. Additional parameters were retrospectively retrieved from the laboratory information system in order to identify possible interfering variables, namely CRP, mean cell volume (MCV) and hematocrit. ESR results of the iSED, when the specimens are stored at room temperature, did not change significantly after 24‐hr collection but ESR results of refrigerated samples increased significantly. We found a negative correlation between ESR results of the Ves‐Matic Cube 200 and iSED with hematocrit levels (r = −0.615, r = −0.441, respectively; P < 0.0001, P < 0.0001, respectively).
This was not clinically significant and within the manufacturer's limit. 1 and 2).
Ninety‐nine volumes blood and one volume lipid solution were mixed. Alcor™ iWASH Cleansing Agent Each bottle provides enough fluid for 150 iSED wash cycles. and you may need to create a new Wiley Online Library account.
The system works directly from dry EDTA tube. Sezer et al. Citrated blood samples were used for ESR measurements by the Westergren method and K2EDTA‐anticoagulated blood samples were used for ESR measurements in the Ves‐Matic Cube 200 system and iSED system.
The nonparametric test of Spearmen's rank correlation was used to evaluate correlation (r, correlation coefficient). Automated measurement of the erythrocyte sedimentation rate: method validation and comparison. Citrate‐diluted blood was aspirated in Westergren pipette, Westergren‐type glass pipettes mounted vertically in a rack. Our findings were in accordance with Curvers et al.
reported CVs for Ves‐MaticCube 200 analyzers as 9.19%, 13.88%, and 5.66% 9. CV% values in low ESR concentrations increase when compared with CV% values in high ESR values.
reported systemic bias as −0.7 and limits of agreement as −32.6 to 31.2; Perovic reported the bias as −0.5, limits of agreement −13.9 to 12.9 in the Ves‐Matic Cube 200 analyzer and Westergren method comparison study 4, 9. Between‐run precision was performed with normal and abnormal controls which were analyzed three times a day for five consecutive days.
Using the StaRRsed as the reference, 103 (85.83%) ESR results from the iSED provided the correct clinical interpretation.