Accuracy of Using a Point-of-Care Glucometer for Cerebrospinal Fluid Glucose Screening in Resource-Limited Countries
Bibliographic record
Abstract
OBJECTIVES: To explore the accuracy of using a point-of-care (POC) glucometer for cerebrospinal fluid (CSF) glucose screening. METHODS: A cross-sectional study was conducted. A glucose analysis of CSF samples collected from infants <90 days with suspected meningitis was paired between tests by using a POC glucometer (POC-CSF glucose) and a laboratory glucose analysis (laboratory-CSF glucose). Accuracy and limits of agreement were compared, as well as the glucometer performance to detect a laboratory-CSF glucose level <45 and 60 mg/dL. RESULTS: Seventy-three CSF samples were analyzed. Subjects' mean gestational age was 32.2 (SD 4.0) weeks, the mean weight was 1947.7 (SD 814.5) g, and the median age was 8 (interquartile range: 2 to 19.5) days. POC-CSF glucose levels ranged from 26 to 126 mg/dL. The mean (±1.96 SD) difference between POC-CSF and laboratory-CSF glucose levels was -1.6 (interquartile range: -12.6 to 9.4) mg/dL. A POC-CSF glucose level <45 mg/dL has a sensitivity and negative predictive value (NPV) to detect a laboratory-CSF glucose level <45 mg/dL of 82% and 94%, respectively. For a laboratory-CSF glucose level <60 mg/dL, a POC glucose level <60 mg/dL provides a sensitivity and NPV of 96% and 90%, respectively, whereas sensitivity and NPV reach 100% at a POC glucose level <70 mg/dL. CONCLUSIONS: A POC glucometer for CSF glucose can detect a potential abnormal glucose level with an appropriate cutoff level. This may facilitate rapid decisions for empirical antibiotics in suspected meningitis, pending laboratory results in limited-resource settings, but requires robust validation in future studies before implementation.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".