Patient self‐testing of white blood cell count and differentiation: A study of feasibility and measurement performance in a population of Danish cancer patients

Home self-testing of complete blood counts in patients with breast cancer during chemotherapy: A proof-of-concept cohort study in e-oncology

BACKGROUND

Before administration of myelosuppressive chemotherapy, complete blood counts (CBC) collected at the hospital/nursing stations are evaluated to avoid severe bone marrow suppression. This maintains disease fixation which often reduces their quality of life. This mixed-method study examined at home self-testing of CBC, the test quality, and the effects on patients' mental well-being.

METHODS

Patients with breast cancer receiving chemotherapy were recruited and trained to perform capillary finger prick CBC testing at home using the HemoScreen Point-of-Care instrument and to upload the test results to the hospital's IT system subsequently. A venous reference CBC sample was taken and tested at the hospital on the day of self-testing. Semi-structured interviews with open-ended components were performed to investigate the user experience and the impact of self-testing on the patients' everyday lives.

RESULTS

Thirty-nine patients completed the self-testing education using the HemoScreen instrument. Eight patients withdrew, while the remaining 31 patients performed 161 home tests (2-11 tests per patient) over a 4-month period. The test results compared well with the venous reference CBCs except for platelet counts (correlation coefficient 0.26). Qualitative interviews with nine of the 31 patients emphasized that the patients were comfortable using the self-testing instrument and becoming an active partner in their own treatment.

INTERPRETATION

CBC self-testing at home produced clinically valid hemoglobin and white blood cell counts with the added benefit that the patients became active partners in their own treatment course, which was of great importance for the patients and increased their wellbeing.

Performance analysis of the compact haematology analyser Sight OLO

INTRODUCTION

Sight OLO is a compact full blood count (FBC) analyser that uses digital imaging techniques and artificial intelligence to count and assess cellular components of capillary or venous blood. It provides a FBC with a 5-part white blood cell differential count. Our aim was to evaluate its performance against our standard analyser and optical microscopy.

METHODS

Comparative studies for the FBC parameters were done between the Sight OLO and the Unicel DxH800 analyser (Beckman Coulter). Evaluation comprised also repeatability studies and reproducibility studies. The flagging efficiency of the Sight OLO was assessed against the reference method (optical microscopy).

RESULTS

The SIGHT OLO showed a good comparability with the Unicel DxH800 analyser for most of the FBC parameters (r > 0.9). The biases recorded between both equipments were within the manufacturer's target specifications for all the FBC parameters. The standard deviation and coefficient of variation calculated per parameter for the precision studies were within the manufacturer's target specifications for all FBC parameters, for all the variation components tested. The five alert flags assessed showed an overall efficiency above 75%, however, high frequency of false negatives was noted for some of the flags assessed.

CONCLUSION

The evaluation of the Sight OLO showed that it can produce accurate FBC results, making it a suitable option for integration in several setups. Its innovative methodology gives it further potential to refine its capabilities.

Point-of-care testing technologies for the home in chronic kidney disease: a narrative review

Point-of-care testing (POCT) performed by the patient at home, paired with eHealth technologies, offers a wealth of opportunities to develop individualized, empowering clinical pathways. The non-dialysis-dependent chronic kidney disease (CKD) patient who is at risk of or may already be suffering from a number of the associated complications of CKD represents an ideal patient group for the development of such initiatives. The current coronavirus disease 2019 pandemic and drive towards shielding vulnerable individuals have further highlighted the need for home testing pathways. In this narrative review we outline the evidence supporting remote patient management and the various technologies in use in the POCT setting. We then review the devices currently available for use in the home by patients in five key areas of renal medicine: anaemia, biochemical, blood pressure (BP), anticoagulation and diabetes monitoring. Currently there are few devices and little evidence to support the use of home POCT in CKD. While home testing in BP, anticoagulation and diabetes monitoring is relatively well developed, the fields of anaemia and biochemical POCT are still in their infancy. However, patients' attitudes towards eHealth and home POCT are consistently positive and physicians also find this care highly acceptable. The regulatory and translational challenges involved in the development of new home-based care pathways are significant. Pragmatic and adaptable trials of a hybrid effectiveness-implementation design, as well as continued technological POCT device advancement, are required to deliver these innovative new pathways that our patients desire and deserve.

Complete Blood Count as point of care testing QBC STAR™: Preliminary evaluation

INTRODUCTION

Point of care testing (POCT) represents a valuable option when laboratory data shall be urgently available for timely clinical management, with a turnaround time (TAT) that is unfeasible using conventional laboratory instrumentation. This study was aimed to compare the performance of QBC STAR™ compared to Sysmex XN-module and the reference optical microscopy (OM) assessment.

MATERIAL AND METHODS

One hundred peripheral blood samples, collected in K₃ EDTA tubes, and 50 capillary blood samples obtained by finger stick were analyzed with QBC STAR™, Sysmex XN-module, and OM. Data were compared with Passing-Bablok regression and Bland-Altman plots.

RESULTS

The Passing-Bablok regression analysis (QBC STAR™ capillary sample vs XN-module) yielded slopes comprised between 0.30 and 1.37, while the intercepts ranged between -17.57 and 232.6. Bland-Altman plots yielded relative bias comprised between -4.87% (for MN QBC STAR™ capillary sample vs XN-module) and 27% (PLT QBC STAR™ capillary sample vs XN-module). A significant bias was found for all parameters except MN and WBC, RBC in all and pediatric samples, and HB in adults samples.

CONCLUSION

The results of this analytical evaluation suggest that QBC STAR™ may not be the ideal tool for performing complete blood count analysis for diagnostic purposes, while it could be more useful in urgent/emergent conditions, such as for rapid monitoring of some hematological parameters (eg, WBC and HB).