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Bell S, Sweeting M, Ramond A, Chung R, Kaptoge S, Walker M, Bolton T, Sambrook J, Moore C, McMahon A, Fahle S, Cullen D, Mehenny S, Wood AM, Armitage J, Ouwehand WH, Miflin G, Roberts DJ, Danesh J, Di Angelantonio E. Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study. Transfus Med 2020; 31:94-103. [PMID: 33341984 PMCID: PMC8048787 DOI: 10.1111/tme.12750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare four haemoglobin measurement methods in whole blood donors. BACKGROUND To safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant's (NHSBT) customary method have been capillary gravimetry (copper sulphate), followed by venous spectrophotometry (HemoCue) for donors failing gravimetry. However, NHSBT's customary method results in 10% of donors being inappropriately bled (ie, with haemoglobin values below the regulatory threshold). METHODS We compared the following four methods in 21 840 blood donors (aged ≥18 years) recruited from 10 NHSBT centres in England, with the Sysmex XN-2000 haematology analyser, the reference standard: (1) NHSBT's customary method; (2) "post donation" approach, that is, estimating current haemoglobin concentration from that measured by a haematology analyser at a donor's most recent prior donation; (3) "portable haemoglobinometry" (using capillary HemoCue); (4) non-invasive spectrometry (using MBR Haemospect or Orsense NMB200). We assessed sensitivity; specificity; proportion who would have been inappropriately bled, or rejected from donation ("deferred") incorrectly; and test preference. RESULTS Compared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect) to 79.0% (portable haemoglobinometry) in men, and from 19.0% (MBR Haemospect) to 82.8% (portable haemoglobinometry) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect) to 99.9% (NHSBT's customary method) in men, and from 74.1% (Orsense NMB200) to 99.8% (NHSBT's customary method) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for portable haemoglobinometry to 18.9% in women for MBR Haemospect. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for NHSBT's customary method to 20.3% in women for OrSense. Most donors preferred non-invasive spectrometry. CONCLUSION In the largest study reporting head-to-head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of NHSBT's customary method with portable haemoglobinometry.
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Affiliation(s)
- Steven Bell
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Michael Sweeting
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Department of Health Sciences, University of Leicester, Leicester, UK
| | - Anna Ramond
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ryan Chung
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Matthew Walker
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas Bolton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jennifer Sambrook
- NHS Blood and Transplant, London, Oxford, Cambridge, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - Carmel Moore
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Anglia Ruskin University, Chelmsford, UK
| | - Amy McMahon
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Sarah Fahle
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Donna Cullen
- NHS Blood and Transplant, London, Oxford, Cambridge, UK
| | - Susan Mehenny
- NHS Blood and Transplant, London, Oxford, Cambridge, UK
| | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jane Armitage
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Willem H Ouwehand
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,NHS Blood and Transplant, London, Oxford, Cambridge, UK
| | - Gail Miflin
- NHS Blood and Transplant, London, Oxford, Cambridge, UK
| | - David J Roberts
- NHS Blood and Transplant, London, Oxford, Cambridge, UK.,Radcliffe Department of Medicine and BRC Biomedical Centre - Haematology Theme, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,NHS Blood and Transplant, London, Oxford, Cambridge, UK
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