Investigation of The Repeatability Performance of Erythrocyte Sedimentation Rate Test

Öz

Objective: In laboratories, the erythrocyte sedimentation rate (ESR) test may need to be repeated for various reasons. The aim of this study was to evaluate the repeatability performance of the ESR test by comparing the ESR values measured after different mixing procedures following the first measurement in sedimentation tubes.
Material and Methods: The sedimentation tubes of 37 samples, which were brought to our clinical biochemistry laboratory for analysis on the same day, were first inverted very lightly and only once after the first measurement, and the second reading was performed. Then, the third reading was performed by inverting the tubes thoroughly and repeatedly.
Results: While the ICC (intraclass correlation coefficient) value between the first and second measurements was 0.868, the ICC value between the first and third measurements was 0.927. In the third measurement, there was a better agreement with the first measurement compared to the second measurement.
Conclusion: In cases where the ESR assay needs to be repeated, sedimentation tubes should be inverted thoroughly and repeatedly. However, despite this application, the compatibility between measurements may not be at the desired level.

Anahtar Kelimeler

• Erythrocyte sedimentation rate
• repeatability
• reliability

ERİTROSİT SEDİMANTASYON HIZI TESTİNİN TEKRARLANABİLİRLİK PERFORMANSININ ARAŞTIRILMASI

Öz

Amaç: Laboratuvarlarda, eritrosit sedimantasyon hızı (ESR) testinin çeşitli sebeplerle tekrarlanması gerekebilmektedir. Bu çalışmanın amacı, sedimantasyon tüplerinde ilk ölçümü takiben yapılan farklı altüst etme işlemlerinden sonra ölçülen ESR değerlerini karşılaştırarak, ESR testinin tekrarlanabilirlik performansını değerlendirmektir.
Gereç ve Yöntemler: Klinik biyokimya laboratuvarımıza aynı gün analiz için gelen 37 numuneye ait sedimantasyon tüpleri, ilk ölçümü takiben, önce çok hafifçe ve bir defaya mahsus olmak üzere altüst edildi ve ikinci okuma yapıldı. Ardından, tüpler iyice ve defalarca altüst edilerek üçüncü okuma gerçekleştirildi.
Bulgular: İlk ve ikinci ölçüm arasındaki ICC (sınıf içi korelasyon katsayısı) değeri 0.868; ilk ve üçüncü ölçüm arasındaki ICC değeri ise 0.927 idi. Üçüncü ölçümlerde, ikinci ölçümlerdekine göre, ilk ölçümle daha iyi bir uyum vardı.
Sonuç: ESR tahlilinin tekrar çalışılması gereken durumlarda, sedimantasyon tüpleri iyice ve birkaç defa altüst edilmelidir. Bununla birlikte, söz konusu uygulamaya rağmen, ölçümler arasındaki uyum istenen seviyede olmayabilir.

Anahtar Kelimeler

• Eritosit sedimentasyon hızı
• tekrarlanabilirlik
• güvenilirlik

Kaynakça

1. 1. Markanday A. Acute phase reactants in infections: evidence-based review and a guide for clinicians. Open Forum Infect Dis. 2015;2(3):ofv098. Doi:10.1093/ofid/ofv098.
2. 2. Bray C, Bell LN, Liang H, Haykal R, Kaiksow F, Mazza JJ et al. Erythrocyte sedimentation rate and C-reactive protein measurements and their relevance in clinical medicine. WMJ. 2016;115(6):317-21.
3. 3. Erdoğdu Hİ, Atalay E. Relationship between high erythrocyte sedimentation rate and 25-hydroxy vitamin D and C-reactive protein levels. Sakarya Med J. 2018;8(4):798-805.
4. 4. Tunç S, Atagün MI, Neşelioğlu S, Bilgin YY, Başbuğ HS, Erel Ö. Ischemia-modified albumin: a unique marker of global metabolic risk in schizophrenia and mood disorders. Psychiatry and clinical psychopharmacology. 2019;29(2):123-9. Doi:10.1080/24750573.2018.1517466.
5. 5. Fabry TL. Mechanism of erythrocyte aggregation and sedimentation. Blood. 1987;70(5):1572-6.
6. 6. Reinhart WH. Erythrocyte sedimentation rate-more than an old fashion? Ther Umsch. 2006;63(1):108-12. Doi:10.1024/0040-5930.63.1.108.
7. 7. Lapic I, Piva E, Spolaore F, Tosato F, Pelloso M, Plebani M. Automated measurement of the erythrocyte sedimentation rate: method validation and comparison. Clin Chem Lab Med. 2019;57(9):1364-73. Doi:10.1515/cclm-2019-0204.
8. 8. Landaas S, Juell A. The quality of laboratory analyses in the primary health care. A proficiency survey on hemoglobin, glucose, leucocyte count and sedimentation rate (ESR) measurements. Scand J Prim Health Care. 1986;4(3):169-73. Doi:10.3109/02813438609014825

9. 9. Dinant GJ, Knottnerus JA, van Wersch JW, Dolhain JP. Erythrocyte sedimentation; a study of the reproducibility of this test in family practice. Ned Tijdschr Geneeskd. 1988;132(15):680-4.
10. 10. Siersema PD, van Eijk HG. The erythrocyte sedimentation rate; a study of the reproducibility of this determination in family practice. Ned Tijdschr Geneeskd. 1988;132(24):1126-7.
11. 11. Dinant GJ, Knottnerus JA, van Aubel PG, van Wersch JW. Reliability of the erythrocyte sedimentation rate in general practice. Scand J Prim Health Care. 1989;7(4):231-5.
12. 12. Dinant GJ, Knottnerus JA, Van Wersch JW. Blood sample transportation and the erythrocyte sedimentation rate. J R Coll Gen Pract. 1989;39(324):302.
13. 13. Lapic I, Piva E, Spolaore F, Musso G, Tosato F, Pelloso M et al. Ves-Matic CUBE 200: is modified Westergren method for erythrocyte sedimentation rate a valid alternative to the gold standard? J Clin Pathol. 2019;72(10):716-9. Doi:10.1136/jclinpath-2019-205873.