Related Experiment Video
Updated: Apr 28, 2026
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Accuracy of continuous noninvasive hemoglobin monitoring: a systematic review and meta-analysis
Sang-Hyun Kim1, Marc Lilot, Linda Suk-Ling Murphy
1From the Departments of Anesthesiology & Perioperative Care, Science Library Reference, and Statistics, University of California Irvine, Orange, California.
Insights
Noninvasive hemoglobin (Hb) monitoring devices show a small mean difference compared to lab tests, but wide agreement limits necessitate caution in clinical decisions. Further evaluation of these Hb monitoring tools is recommended.
Area of Science:
- Clinical Chemistry
- Medical Devices
- Biomedical Engineering
Background:
- Noninvasive hemoglobin (Hb) monitoring devices are increasingly used in clinical settings.
- The accuracy and precision of these devices against traditional laboratory Hb measurements require rigorous evaluation.
- Existing literature lacks a systematic review and meta-analysis to consolidate accuracy data.
Purpose of the Study:
- To systematically review and meta-analyze the accuracy and precision of noninvasive Hb monitoring devices.
- To compare noninvasive Hb measurements with central laboratory Hb reference standards.
- To assess the reliability of noninvasive Hb monitoring for clinical decision-making.
Main Methods:
- A comprehensive literature search was conducted from 2005 to August 2013 across major databases (PubMed, Web of Science, Cochrane Library).
- Study quality was independently assessed by two reviewers using established guidelines and criteria for method comparison studies.
- Random-effects meta-analysis was employed to calculate pooled mean difference and standard deviation (SD), including 95% limits of agreement.
Main Results:
- A total of 32 studies involving 4425 subjects were included in the meta-analysis.
- The overall pooled mean difference was 0.10 ± 1.37 g/dL, with wide limits of agreement (-2.59 to 2.80 g/dL).
- Subgroup analysis showed variations, with perioperative settings yielding a mean difference of 0.39 ± 1.32 g/dL and intensive care units -0.51 ± 1.59 g/dL.
Conclusions:
- While the average difference between noninvasive and laboratory Hb measurements is small, the broad limits of agreement are significant.
- Clinicians must exercise caution when interpreting noninvasive Hb readings for critical patient management.
- The current performance of noninvasive Hb monitoring devices warrants careful consideration in clinical practice.
Background:
Noninvasive hemoglobin (Hb) monitoring devices are available in the clinical setting, but their accuracy and precision against central laboratory Hb measurements have not been evaluated in a systematic review and meta-analysis.
Methods:
We conducted a comprehensive search of the literature (2005 to August 2013) with PubMed, Web of Science and the Cochrane Library, reviewed references of retrieved articles, and contacted manufactures to identify studies assessing the accuracy of noninvasive Hb monitoring against central laboratory Hb measurements. Two independent reviewers assessed the quality of studies using recommendations for reporting guidelines and quality criteria for method comparison studies. Pooled mean difference and standard deviation (SD) (95% limits of agreement) across studies were calculated using the random-effects model. Heterogeneity was assessed using the I statistic.
Results:
A total of 32 studies (4425 subjects, median sample size of 44, ranged from 10 to 569 patients per study) were included in this meta-analysis. The overall pooled random-effects mean difference (noninvasive-central laboratory) and SD were 0.10 ± 1.37 g/dL (-2.59 to 2.80 g/dL, I = 95.9% for mean difference and 95.0% for SD). In subgroup analysis, pooled mean difference and SD were 0.39 ± 1.32 g/dL (-2.21 to 2.98 g/dL, I = 93.0%, 71.4%) in 13 studies conducted in the perioperative setting and were -0.51 ± 1.59 g/dL (-3.63 to 2.62 g/dL, I = 83.7%, 96.4%) in 5 studies performed in the intensive care unit setting.
Conclusions:
Although the mean difference between noninvasive Hb and central laboratory measurements was small, the wide limits of agreement mean clinicians should be cautious when making clinical decisions based on these devices.
More Related Videos
14:28Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care
Published on: May 10, 2024
07:12Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
Published on: November 19, 2020
Related Concept Videos
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:25Errors occurring during blood pressure monitoring
Several factors...
01:23Holter Monitor: 24-Hour Monitoring
01:30Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:24Pulse Oximetry
Purpose
Average SpO2 values are greater than 95%. If the readings fall below 90%, it indicates that...
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...