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Updated: Jan 8, 2026
Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
Published on: March 24, 2023
Evaluation of the VISION Pro Analyzer for Automated Erythrocyte Sedimentation Rate Measurement: Is It a Suitable
Ana Nikler1, Iva Bakarić1, Denis Zilić2
1Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia.
Introduction:
Erythrocyte sedimentation rate (ESR) is a widely used inflammation marker. VISION Pro (Shenzhen YHLO Biotech Co. LTD, Shenzhen, China) is a fully automated ESR analyzer. This study verified its analytical performance and comparability to the manual Westergren method.
Methods:
Inter- and intra-run precision study was assessed using control and patient samples at low, medium, and high ESR levels. Accuracy was evaluated by comparing 240 K2EDTA (ethylenediaminetetraacetic acid) whole blood samples with the Westergren method in citrate divided by ESR subgroups (< 40, 40-80, > 80 mm). Sample stability was tested in 8 samples at room temperature and 2°C-8°C over 24 h. Reference range verification included 40 healthy individuals (20 male, 20 female). The effects of testing order for ESR and complete blood count (CBC) (ESR/CBC/ESR vs. CBC/ESR/CBC) and analysis modes (Cycle, Random, Mixer+Random) were also explored.
Results:
Inter- and intra-run precision were acceptable at medium and high ESR levels without temperature correction, while low levels exceeded acceptable criteria (e.g., CV = 24.4% vs. criterion 11.3%). Agreement with Westergren was excellent, with no significant differences (intercept = 1.1 [95% CI: 0.0-1.4]; slope = 1.0 [95% CI: 0.9-1.0]), while temperature-corrected results showed unsatisfactory agreement (intercept = -0.1 [95% CI: -0.7 to 0.4]; slope = 0.8 [95% CI: 0.7-0.8]). Sample stability was maintained for up to 3 h at room temperature and up to 10 h at 2°C-8°C. Reference range verification demonstrated all 20 samples within limits for men and 19/20 for women, while only 17/20 for temperature-corrected results for women. ESR/CBC/ESR order minimally affected the results (14/15 acceptable), while CBC/ESR/CBC order influenced CBC parameters (predominantly MPV). No significant differences occurred between measurement modes (p = 0.093).
Conclusion:
VISION Pro analyzer demonstrated acceptable ESR measurement performance without temperature correction and is suitable for routine laboratory use. Temperature-corrected results showed inconsistent performance and require cautious interpretation.
