Real-world smartphone-based point-of-care diagnostics in primary health care to monitor HbA1c levels in people with diabetes
- authored by
- Sabrina Rhode, Lisa Rogge, Marthoenis Marthoenis, Till Seuring, Hendra Zufry, Till Bärnighausen, Hizir Sofyan, Jennifer Manne-Goehler, Sebastian Vollmer
- Abstract
Background: The lack of accurate and affordable monitoring of glycated hemoglobin (HbA1c) is a common issue among patients with diabetes in low- and middle-income countries. We aimed to test a tablet- and smartphone-based point-of-care (TSB POC) device against a local laboratory-based measure of HbA1c for monitoring diabetes under real-world conditions. Methods: For this cross-sectional clinical method applicability study, capillary and venous blood was collected in duplicate and analyzed at local primary health care centers. For a heterogeneity test, the tests were performed by an expert, and by a team of local nurses. The study was conducted in a multicenter design in rural and urban Aceh, Indonesia in 2019, and included a total of 533 adults. We mainly used Bland-Altman plots to assess the number of readings within the 95%-limits of agreement (LoA) and Deming regressions. Results: The results show a mean difference between capillary HbA1c on the test device and the reference method of −0.54 [CI0.95 = −1.6933; 0.6048] with 5.21% of measurements outside the LoA and a Pearson’s r = 0.91 in the Deming Regression. There is no significant difference in test concordance between local nurses and the expert (4.23% versus 5.13% results outside the LoA [CI0.95 = −0.0331; 0.0511]). Conclusions: TSB POC for analysis of HbA1c is an acceptable alternative for accessible monitoring of diabetes patients under these conditions. This method could provide access to high-quality diagnostic decisions through regular and cost-effective HbA1c monitoring directly in healthcare facilities, thus providing better access to essential health services.
- Organisation(s)
-
Institute of Labour Economics
- External Organisation(s)
-
Heidelberg University
University of Göttingen
Universität zu Lübeck
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU Erlangen-Nürnberg)
Universitas Syiah Kuala
Luxembourg Institute of Socio-Economic Research (LISER)
Zoeinal Abidin Regional General Hospital (RSUDZA)
Harvard University
- Type
- Article
- Journal
- Communications Medicine
- Volume
- 5
- ISSN
- 2730-664X
- Publication date
- 05.02.2025
- Publication status
- Published
- Peer reviewed
- Yes
- ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health, Internal Medicine, Epidemiology, Medicine (miscellaneous), Assessment and Diagnosis
- Sustainable Development Goals
- SDG 3 - Good Health and Well-being
- Electronic version(s)
-
https://doi.org/10.1038/s43856-025-00743-8 (Access:
Open)
