Evaluation of incompatibility in measurement of erythrocyte sedimentation rate by two different modes of automated analyzer and demonstration of surpassing with a manipulation

Abstract

Objectives: Erythrocyte sedimentation rate (ESR) is an elementary and low-cost point of care test commonly used to investigate inflammatory activity, not used for the diagnosis of any particular disease. The present study aims to investigate the diversity in measurements within ESR analyzer modes and demonstrate an alternative manipulation which can reduce the diversity among the modes. Methods: Measurements were performed in three groups (cycle mode, random mode, manipulation using application of shaker before running random mode) by VISION ESR analyzer on a randomly selected 120 patients' sample from the central laboratory. Statistical analysis was performed with IBM SPSS 20.0 Software. The data were also evaluated using the Bland-Altman method to compare three groups and related subgroups. Results: In all groups, we found the statistical differences between cycle mode and random mode (P=0.00). In our study, the findings showed that adding the shaker process in random mode yields more optimum results in ESR values, which was higher than 20 mm/h (P=0.295). Conclusion: According to our analysis, the findings suggest that the compatibility between cycle mode and random mode is weaker; therefore, in clinical laboratory routine, it is preferably recommended to use cycle mode. When oper-ators use random mode, it is more likely recommended, to ensure that the K3-EDTA tubes are exactly mixed with the samples not only manually mixing but also applied shaker process.