{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T12:18:24Z","timestamp":1775909904704,"version":"3.50.1"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100009051","name":"Secretar\u00eda de Salud","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Several external and internal factors can affect the performance and variability of Hemoglobin concentration [Hb] measurements using HemoCue, and documentation on the contribution of different sources of [Hb] variation is limited. We used an experimental repeated measurements design with nine randomly selected participants, three HemoCue devices, and three trained field workers. HemoCue measurements for all samples were repeated three times. The [Hb] measurement system considers four sources of error: 1) HemoCue devices, 2) field workers, 3) between individuals, and 4) within individuals. A concordance analysis was used to assess accuracy and precision, and a linear mixed model was used to estimate mean differences (bias) from blood specimens, anticoagulants, and to estimate the contribution of the 4 sources of error to [Hb] measurements. Positive mean [Hb] differences were found: 1.34 g\/dL for capillary drops, 0.81 g\/dL for pooled capillary blood samples, 0.756 g\/dL for venous blood stored with EDTA, and 0.911 g\/dL for venous blood stored with heparin. The mean [Hb] difference for venous blood with EDTA was used as a correction factor for all results measured using a HemoCue. After adjustment, capillary drops showed a mean difference of 0.585 g\/dL, and pooled capillary samples were not significantly different. The individual variability was 95.8% of total variance, HemoCue devices contributed 2.1% of measurement error, field staff contributed 0.4%, and the residual was 1.7%. The HemoCue [Hb] measurement system is reliable in controlled environments, with a small measurement error of 4.2%.<\/jats:p>","DOI":"10.1371\/journal.pone.0312233","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T17:29:12Z","timestamp":1729877352000},"page":"e0312233","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Capillary drops, capillary pooled, and venous blood samples for determining hemoglobin concentration using HemoCue: A measurement system analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3908-0867","authenticated-orcid":true,"given":"Ignacio","family":"M\u00e9ndez-G\u00f3mez-Humar\u00e1n","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0408-6580","authenticated-orcid":true,"given":"Vanessa","family":"De la Cruz-G\u00f3ngora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Dary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Shamah-Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"pone.0312233.ref001","article-title":"Comparing Hemoglobin Distributions between Population-Based Surveys Matched by Country and Time","author":"D.J. Hruschka","year":"2020","journal-title":"BMC Public Health"},{"issue":"5","key":"pone.0312233.ref002","doi-asserted-by":"crossref","first-page":"E627","DOI":"10.1016\/S2214-109X(22)00084-5","article-title":"National, Regional, and Global Estimates of Anaemia by Severity in Women and Children for 2000\u201319: A Pooled Analysis of Population-Representative Data","volume":"10","author":"GA Stevens","year":"2022","journal-title":"Lancet Glob Health"},{"key":"pone.0312233.ref003","doi-asserted-by":"crossref","DOI":"10.1136\/jclinpath-2020-206717","article-title":"Variability in Haemoglobin Concentration by Measurement Tool and Blood Source: An Analysis from Seven Countries","volume":"74","author":"A.I. Rappaport","year":"2021","journal-title":"J Clin Pathol"},{"key":"pone.0312233.ref004","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-005756","article-title":"Preanalytic and Analytic Factors Affecting the Measurement of Haemoglobin Concentration: Impact on Global Estimates of Anaemia Prevalence","volume":"6","author":"L.M. Larson","year":"2021","journal-title":"BMJ Glob Health"},{"key":"pone.0312233.ref005","article-title":"Methods and Analyzers for Hemoglobin Measurement in Clinical Laboratories and Field Settings","author":"R.D. Whitehead","year":"2019","journal-title":"Ann N Y Acad Sci"},{"key":"pone.0312233.ref006","article-title":"Effects of Preanalytical Factors on Hemoglobin Measurement: A Comparison of Two HemoCue\u00ae Point-of-Care Analyzers","author":"R.D. Whitehead","year":"2017","journal-title":"Clin Biochem"},{"key":"pone.0312233.ref007","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1590\/S0036-36342002000300005","article-title":"Hemoglobin Measured by Hemocue and a Reference Method in Venous and Capillary Blood: A Validation Study","volume":"44","author":"L. Neufeld","year":"2002","journal-title":"Salud Publica Mex"},{"key":"pone.0312233.ref008","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/BF02722739","article-title":"Validation of Hemoglobin Estimation Using Hemocue","volume":"70","author":"P. Bhaskaram","year":"2003","journal-title":"Indian J Pediatr"},{"key":"pone.0312233.ref009","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1136\/jclinpath-2017-204786","article-title":"Comparison of Haemoglobin Assessments by HemoCue and Two Automated Haematology Analysers in Young Laotian Children","volume":"71","author":"G.M. Hinnouho","year":"2018","journal-title":"J Clin Pathol"},{"key":"pone.0312233.ref010","unstructured":"INCAP\/OPS\/USAID. Informe de Resultados Fase A: Verificaci\u00f3n de La Confiabilidad de Los Equipos HemoCue\u00ae y El Tipo de Extracci\u00f3n Sangu\u00ednea En La Determinaci\u00f3n de Hemoglobina (Proyecto \u201cGeneraci\u00f3n de Informaci\u00f3n V\u00e1lida y Confiable Sobre Deficiencias de Micronutrientes en Ni\u00f1os de 6\u201359 Meses y Mujeres en Edad F\u00e9rtil Residentes en Siete Comunidades del Departamento de Intibuc\u00e1 en Honduras\"). Tegucigalpa: INCAP, 2019."},{"key":"pone.0312233.ref011","volume-title":"Introduction to Statistical Quality Control","author":"Douglas C. Montgomery","year":"2013","edition":"7"},{"key":"pone.0312233.ref012","unstructured":"Evaluating the Measurement Process & Using Imperfect Data. SPC Press."},{"key":"pone.0312233.ref013","volume-title":"Measurement Systems Analysis, MSA","author":"AIAG","year":"2010","edition":"4"},{"key":"pone.0312233.ref014","volume-title":"Drug-Delivery Devices Measurement-System Analysis Using Gauge R&R Studies","author":"A. Marinelli","year":"2022"},{"key":"pone.0312233.ref015","doi-asserted-by":"crossref","DOI":"10.3390\/nu14245346","article-title":"Drops of Capillary Blood Are Not Appropriate for Hemoglobin Measurement with Point-of-Care Devices: A Comparative Study Using Drop Capillary, Pooled Capillary, and Venous Blood Samples","volume":"14","author":"V. De la Cruz-G\u00f3ngora","year":"2022","journal-title":"Nutrients"},{"key":"pone.0312233.ref016","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1136\/jcp.51.3.248","article-title":"Measurement of Haemoglobin Using Single Drops of Skin Puncture Blood: Is Precision Acceptable?","volume":"51","author":"A.M. Conway","year":"1998","journal-title":"J Clin Pathol"},{"key":"pone.0312233.ref017","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1309\/AJCP1L7DKMPCHPEH","article-title":"Drop-to-Drop Variation in the Cellular Components of Fingerprick Blood: Implications for Point-of-Care Diagnostic Development","volume":"144","author":"M.M. Bond","year":"2015","journal-title":"Am J Clin Pathol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T17:29:22Z","timestamp":1729877362000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312233"}},"subtitle":[],"editor":[{"given":"Bachti","family":"Alisjahbana","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,10,25]]},"references-count":17,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312233","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,25]]}}}