Different DCCT-aligned HbA1c methods and the GMS contract

International Journal of Clinical Practice
P J Twomey, D R Pledger

Abstract

Previously, different analytical methods could be compared on statistical and clinical grounds. Since 2003, the UK Departments of Health and general practitioners agreed a new primary care contract. This contract utilises clinical targets resulting in a third way to compare analytical methods. We compared two DCCT-aligned HbA1c analysers (Variant II analyser and a Tosoh G7) using 161 randomly selected patient specimens to see if different methods could lead to a difference in the classification for glycaemic control. Ninety-seven (60.2%) and 109 (67.7%) patient specimens had a HbA1c <or= 7.4% with the Variant II analyser and Tosoh G7 respectively, that is, the two methods differed according to the DM6 GMS target by 12 patients or 7.5% of the total number of patients in the study. When McNemar's test was performed, the difference between the two methods was statistically significant with p<0.00083. The National Glycohemoglobin Standardisation Programme has used clinical limits to set standards for HbA1c based on a clinical recommendation from the American Diabetes Association and has resulted in improved generalisability of results. The difference found in this study would not have affected payment under the current GMS contract...Continue Reading

References

Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Dec 23, 2003·Current Medical Research and Opinion·Patrick J TwomeyTimothy M Reynolds
Mar 30, 2004·Journal of Clinical Pathology·E S Kilpatrick
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Mar 16, 2006·Annals of Clinical Biochemistry·Patrick J Twomey
Jul 29, 2006·Journal of Clinical Pathology·W S A SmellieC Waine
Sep 16, 2006·BMJ : British Medical Journal·Timothy M ReynoldsPatrick J Twomey
Jan 18, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·P J TwomeyD R Pledger

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Citations

Apr 9, 2014·Semergen·M C Villar-del-CampoS Donnay-Pérez
Dec 3, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·Kazuo InoueKimihiko Akimoto
Jun 9, 2009·Diabetes Care·Peter S KimColleen Hadigan
Dec 17, 2014·Clinical Chemistry and Laboratory Medicine : CCLM·Siri CarlsenSverre Sandberg
Mar 21, 2009·Current Opinion in Endocrinology, Diabetes, and Obesity

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