Understanding Variation in the Value of Esr in Anaemic Patients Using Different Automated Analysers And Its Comparison With Gold Standard Westergren Method
Year: 2025
Type: article
Abstract: This study was conducted on 500 samples in the Department of Haematology, Dr Lal path labs, National Reference Laboratory, Rohini, Delhi, to analyse the variation in the value of ESR in anaemic patients using different automated analysers and its comparison with gold standard, Westergren method.Samples with Hb < 11gm% and hct < 35% were included in the study, these samples were initially analysed in automated ESR analysers-AlcoriSed as (method 1) and then in Alifax test1 analyser as (method 2) and subsequently by the manual Westergren method.Fabry's formula was used to correct the Westergren ESR.The observed ESR was graded as normal (n=110), Intermediate (n=192), High (n=194) and very high (n=4).The mean difference between corrected ESR and Alcor iSed(Method 1) for normal, intermediate, high and very high was 22.8, 39.1,62.3 and 93.1 mm/hr respectively.Bland Altman analysis of Alcor iSed and the Westergren method show wide limits of agreement (LOA) range from -47.2 mm/hr to +56.6 mm/hr, between the two methods, particularly at higher ESR values.The comparison between Alifax test 1 and the Westergren method observed a mean difference with LOA of 22.8 (-29.7 to 62.3),39.7 (-36.4 to 50.6), 63.8 (-48.1 to 47.7) and 92.1 (-106.5 to 36.3)mm/hr respectively for normal intermediate high and very high ESR.Bland Altman analysis of the same observed a mean difference (bias) of 5.96 mm/hr with LOA ranging from -42.1 mm/hr to +54.0 mm/hr, indicating a considerable spread in differences.The mean difference (bias) between the two automated analysers of -1.24 mm/hr suggests a slight difference in estimation of ESR values by the Alcor iSed compared to the Alifax test1.In referral laboratories with copious sample loads, the automated ESR analysers can safely replace the Westergren method for normal to intermediate ESR values in anaemic patients.The result deteriorates as ESR values increase (>100mm/hr) leading to greater variability and reduced correlation in the high and very high ESR.In anaemic patients with high ESR (>100mm/hr), confirmation and verification by the standard Westergren method may be required.
Author: A Gupta
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411712247