Cross-sectional evaluation of two point-of-care glucose meters against the GOD-PAP reference method

Muhammad Jalil Razak; Nur  Ismi; Marisca Jenice Sanakya; Suprapto Suprapto

doi:10.61099/jih.v2i3.479

Authors

Muhammad Jalil Razak Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi
Nur Ismi Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi
Marisca Jenice Sanakya Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi https://orcid.org/0000-0002-4070-4331
Suprapto Suprapto Departement of Nursing, Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0000-0003-4294-1469

DOI:

https://doi.org/10.61099/jih.v2i3.479

Keywords:

accuracy, blood glucose, Bland–Altman analysis, point-of-care testing, precision

Abstract

Introduction: Point-of-care testing (POCT) for blood glucose measurement is increasingly used because it provides rapid results for clinical decision-making. However, its analytical performance must be evaluated before routine implementation. This study aimed to compare the precision, accuracy, and agreement of the Easy Touch and Emtech BG Max 1 POCT devices with the Glucose Oxidase–Peroxidase (GOD-PAP) reference method for blood glucose measurement.

Research Methodology: An observational analytic study with a cross-sectional design was conducted at the Buton Tengah Regional General Hospital Laboratory, Indonesia. Fifty venous blood samples were analyzed using the Easy Touch and Emtech BG Max 1 POCT devices and the GOD-PAP laboratory method as the reference standard. Precision was evaluated using the coefficient of variation (CV), accuracy was assessed through percentage bias and compliance with ISO 15197:2013, and agreement was determined using nonparametric Bland–Altman analysis.

Results: The CV values were 5.54% for Easy Touch, 1.76% for Emtech BG Max 1, and 0.80% for the GOD-PAP method. The mean bias was 7.74% for Easy Touch and −5.78% for Emtech BG Max 1. Compliance with ISO 15197:2013 was achieved in 62% of Easy Touch measurements and 90% of Emtech BG Max 1 measurements. Bland–Altman analysis demonstrated good agreement between both POCT devices and the reference method. However, Emtech BG Max 1 showed narrower limits of agreement and closer agreement with GOD-PAP than Easy Touch.

Conclusion: Both POCT devices demonstrated acceptable analytical agreement with the GOD-PAP method for blood glucose testing. However, Emtech BG Max 1 exhibited superior precision, lower analytical bias, and higher compliance with ISO 15197:2013, indicating greater reliability for routine clinical use. Periodic analytical performance evaluation is recommended to maintain the quality and accuracy of POCT-based blood glucose testing.

Downloads

Download data is not yet available.

References

1. Aickareth G, Jain S, Patel S, Zeitouni J, Griswold J, Dhanasekara CS. Retrospective study comparing predicted and measured resting energy expenditure in burn patients with obesity. Clin Nutr ESPEN. 2025;70:489-500. doi:https://doi.org/10.1016/j.clnesp.2025.10.028

2. Barua S, A Wierzchowska-McNew R, Deutz NEP, Sabharwal A. Discordance between postprandial plasma glucose measurement and continuous glucose monitoring. Am J Clin Nutr. 2022;116(4):1059-1069. doi:https://doi.org/10.1093/ajcn/nqac181

3. Chandra Prabhakar M, Halder P. Reliability and accuracy of bedside capillary blood glucose measurement by glucometers compared to venous blood glucose in critically ill patients: A facility based cross-sectional study. Clin Nutr ESPEN. 2024;60:24-30. doi:https://doi.org/10.1016/j.clnesp.2024.01.008

4. Garcia VR, Ezzat Abdel-Aziz T, de Jong MC, et al. Point-of-care ionised calcium testing: lab validation and clinical feasibility study. Endocr Connect. 2025;14(9). doi:https://doi.org/10.1530/EC-25-0337

5. Haas NL, Ang L, Esfandiari NH, et al. Analytical Accuracy of a Continuous Glucose Monitor in Adult Diabetic Ketoacidosis. CHEST Crit Care. 2025;3(1):100109. doi:https://doi.org/10.1016/j.chstcc.2024.100109

6. Huang T-Y, Chen Y-H, Li Y-C, Chiu Y-H, Kang H-J, Chen C-Y. Accuracy validation and user performance analysis of two new self-monitoring blood glucose systems. Endocrinol Diabetes Metab Case Reports. 2025;2025(1). doi:https://doi.org/10.1530/EDM-24-0134

7. Hughes K, Moore C, Woods S, Wilkes E. Precision and accuracy of a point of care glucometer for detection of hypoglycaemia in horses. Vet J. 2024;305:106109. doi:https://doi.org/10.1016/j.tvjl.2024.106109

8. Jávorfi T, Kocsis G, Svébis MM, et al. Glucose management indicator: Do we need device-specific equations? Diabetes Metab. 2025;51(4):101661. doi:https://doi.org/10.1016/j.diabet.2025.101661

9. Johannis W, Meyer A, Elezagic D, Streichert T. Measuring capillary blood glucose concentration: Is the first blood drop really the right blood drop? Prim Care Diabetes. 2023;17(6):581-586. doi:https://doi.org/10.1016/j.pcd.2023.08.005

10. Krämmer BR, Silveira RC, Costa EC, Mendes ML, Procianoy RS, Filho GG. Evaluation of stretched penile length (SPL), postnatal penile growth evolution, and micropenis in Brazilian preterm newborns. J Pediatr (Rio J). 2025;101(6):101437. doi:https://doi.org/10.1016/j.jped.2025.101437

11. Murray JS, Williams CJ, Lendrem C, et al. Patient Self-Testing of Kidney Function at Home, a Prospective Clinical Feasibility Study in Kidney Transplant Recipients. Kidney Int Reports. 2023;8(6):1170-1182. doi:https://doi.org/10.1016/j.ekir.2023.03.003

12. Nachman D, Eisenkraft A, Rahamim E, et al. Assessing Cardiac Flow Measurements Using a Noninvasive Photoplethysmography-Based Device Compared to Invasive Pulmonary Artery Catheter. JACC Adv. 2025;4(9):102093. doi:https://doi.org/10.1016/j.jacadv.2025.102093

13. Pan J, Zhang R, Xia S, Yang M, Jiang L, Yi C. High-throughput point-of-care testing using the smartphone-based, cloud computing-enabled ECL analyzer and single ITO electrode-based sensing chips. Microchem J. 2025;209:112707. doi:https://doi.org/10.1016/j.microc.2025.112707

14. Panwar S, Kasim DS, Singh H, et al. A non-invasive device for glucose monitoring through saliva – a paradigm shift in diabetes care††Electronic supplementary information (ESI) available. See DOI: https://doi.org/10.1039/d5sd00027k. Sensors and Diagnostics. 2025;4(8):680-689. doi:https://doi.org/10.1039/d5sd00027k

15. Proulx M-P, Vergneau-Grosset C, Hébert J, Bédard C, Maccolini É. Comparison of a portable blood glucose meter analyzer with a benchtop point-of-care chemistry analyzer for measurement of blood glucose concentration in client-owned ferrets (Mustela putorius furo). J Exot Pet Med. 2022;43:22-28. doi:https://doi.org/10.1053/j.jepm.2022.07.004

16. Ravelo AD, Ruch M, Salfer IJ, Caixeta LS. Comparison of glucose concentrations in samples frozen for varying durations and subjected to freeze-thaw cycles using 2 assay systems. JDS Commun. 2025;6(4):610-615. doi:https://doi.org/10.3168/jdsc.2024-0729

17. Renaud DL, Hare KS, Wood KM, Steele MA, Cantor MC. Evaluation of a point-of-care meter for measuring glucose concentrations in dairy calves: A diagnostic accuracy study. JDS Commun. 2022;3(4):301-306. doi:https://doi.org/10.3168/jdsc.2021-0190

18. Rosengrave PC, Wohlrab C, Spencer E, Williman J, Shaw G, Carr AC. Effect of intravenous vitamin C on arterial blood gas analyser and Accu-Chek point-of-care glucose monitoring in critically ill patients. Crit Care Resusc. 2022;24(2):175-182. doi:https://doi.org/10.51893/2022.2.OA7

19. Santamaria JD, Selers E, Reid D. Accuracy of continuous glucose monitoring in critically ill patients. Crit Care Resusc. 2025;27(4):100118. doi:https://doi.org/10.1016/j.ccrj.2025.100118

20. Srinivasan B, Ghosh S, Webb P, et al. Assessing an aflatoxin exposure biomarker: Exploring the interchangeability and correlation between venous and capillary blood samples. Environ Res. 2022;215:114396. doi:https://doi.org/10.1016/j.envres.2022.114396

21. Suprapto, Yuriatson, Menga MK, et al. Strategies to improve health service quality in Indonesia: a qualitative study. BMC Health Serv Res. Published online June 18, 2026. doi:10.1186/s12913-026-14221-x

22. Takagi T, Fujii T, Nakamura S, Tsutsumi Y, Uezono S. Accuracy of Pulse Oximetry and Risk Factors Associated With Discrepancy From Arterial Oxygenation in Asian Patients in the ICU: An Observational Study. Chest. 2025;168(3):650-660. doi:https://doi.org/10.1016/j.chest.2025.03.006

23. Thakur V, Akerele OA, Randell E. Validation of glucose and lactate in cerebrospinal fluid (CSF) on a Radiometer blood gas analyzer ABL90 Flex plus. Clin Biochem. 2025;136:110876. doi:https://doi.org/10.1016/j.clinbiochem.2025.110876

24. Torriero AAJ, Fitz MJ, Mruthunjaya AK V. Calibration-free disposable electrochemical sensor with co-facing electrodes for viscosity monitoring of plasma samples. Talanta. 2025;285:127290. doi:https://doi.org/10.1016/j.talanta.2024.127290

25. Ukpe MP, Ezeanuka AC. Assessment of accuracy, clinical validity, and analytical linearity in point-of-care glucose monitoring devices for diabetes mellitus: A systematic review and meta-analysis. Clin Biochem. 2025;137:110911. doi:https://doi.org/10.1016/j.clinbiochem.2025.110911

26. Xu W, Wells CI, Seo SHB, et al. Feasibility and Accuracy of Wrist-Worn Sensors for Perioperative Monitoring During and After Major Abdominal Surgery: An Observational Study. J Surg Res. 2024;301:423-431. doi:https://doi.org/10.1016/j.jss.2024.06.038

27. Yohan Trayanus Lasarus Djaha, Maria Kurni Menga, Darmi Arda. Fasting Blood Glucose with Serum Creatinine Levels in Type 2 Diabetes Mellitus Patients. J Interdiscip Heal. 2026;2(2):92 – 100. doi:https://dx.doi.org/10.61099/jih.v2i2.259