Pilot study of the accuracy of bedside glucometry in the intensive care unit
Bibliographic record
Abstract
OBJECTIVE: To evaluate the accuracy of bedside glucometry among critically ill patients. DESIGN: Prospective audit, with sequential specimen collection. SETTING: Thirty-two-bed cardiovascular, neurosurgical, and medical-surgical intensive care unit in a single Canadian center. PATIENTS: Ten critically ill adults, who were sequentially followed during their intensive care unit stay. Eight had diabetes mellitus, and three were in shock. MEASUREMENTS AND MAIN RESULTS: Repeat arterial blood samples were obtained by the attending nurse, who withdrew a portion of the sample and performed reflectance glucometry at the bedside. The remainder was immediately sent in a vacuum-sealed plasma separation tube to the hospital laboratory, and analyzed using a conventional plasma glucose analyzer by a laboratory technologist. Sequential samples were taken at intervals of at least 12 hrs of one other. A total of 105 arterial glucose pairs were obtained. There was a significant correlation between the laboratory and glucometry determined glucose concentrations (intraclass correlation coefficient = 0.86, p <.0001). The overall average laboratory-glucometry glucose difference was -0.04 mmol/L (95% confidence interval [CI] -2.3-2.2 mmol/L). Five out of 105 values (4.8%) lay beyond these confidence bounds. The square of the Pearson correlation coefficient (r(2)) between the mean glucose level and the laboratory-glucometry glucose difference was not significant (0.01, 95% CI 0.005-0.04; p =.22), suggesting the absence of any trend between rising glucose concentration and the laboratory-glucometry difference. CONCLUSIONS: Bedside glucose testing of arterial whole blood samples may be an accurate alternative to laboratory plasma glucose measurement among critically ill adults, within approximately 2.3 mmol/L of certainty. Because previous studies have suggested that this bedside technique may be prone to a moderate degree of error among patients in shock as well as those with an abnormal blood pH or hematocrit, larger studies are needed to confirm our findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".