Disclaimer: This is an example of a student written essay.
Click here for sample essays written by our professional writers.

Any scientific information contained within this essay should not be treated as fact, this content is to be used for educational purposes only and may contain factual inaccuracies or be out of date.

Reliability of Reflotron in Testing of Total Cholesterol

Paper Type: Free Essay Subject: Chemistry
Wordcount: 1735 words Published: 30th Jan 2018

Reference this

Reliability of Reflotron in Testing of total Cholesterol and Urea in Non- centralized Medical Setting


Point-of-care testing (PoCT) has been defined as “those analytical patient-testing activities provided within the institution, but performed outside the physical facilities of the clinical laboratories (1). There has been a growing interest in point-of-care testing (PoCT) because of its advantages over standard laboratory procedures, it provides timely information to medical teams, facilitating rational, time-critical decisions, and has been demonstrated to improve patient outcomes in critical care settings (2). At least a dozen portable cholesterol and urea – testing instruments have been designed for use in community and office settings. These instruments have made mass screenings for these risk factors feasible and thus are now in widespread use for this purpose (3).

Dyslipidemia; including both hypercholesterolemia and hypertriglyceridemia represent significant risk factors for the development of peripheral artery diseases and negative health outcomes (4, 5).

High blood cholesterol increases the risk of heart disease, is a major modifiable risk factor, and contributes to the leading cause of death in the USA (6,7).

Chronic kidney disease (CKD) is now recognized as a major world-wide health problem (8). A method for the estimation of the urea in blood coming from individual organs and for clinical purposes must be efficient when only small quantities of blood can be obtained (9).

Aim of work:

In Arar city many non- centralized Medical Setting used Reflotron for medical analysis and diagnosis disease. The purpose of this study was to assess the validity of Reflotron in the testing of total cholesterol and urea for screening and diagnosis in Arar city.


Cross sectional study held in Arar city in the period from 1 November 2013 to 10 November 2013, 30 blood sample was taken and measured by Reflotron apparatus and the results was rechecked by Dimension RXI MAX –apparatus to compare between the results between 2 methods.

Approximately 20ml of blood was collected from each participant, after fasting for 12h, using standardized venipuncture techniques in the antecubital vein in the bend of the elbow. In order to overcome technician error, two drops of blood (30μl) were collected immediately from the previously drawn venous sample by drawing blood into the capillary tube from the opening in the top of the venous tube before centrifuging the venous sample, rather than ‘sticking’ the finger.

Statistical analysis was done by SPSS 20 and suitable statistical methods were used, p<0.05 is considered significant


Table (1): Comparison between Reading of Reflotron and Dimension RXI MAX test:






Urea (mg/dl)










Total cholesterol (mg/dl)











Table 1 shows that the mean of urea was 65.22±46.3 by Dimension RXI MAX apparatus while it was 63.73±41.1 by Reflotron, as regards Total cholesterol mean by Dimension RXI MAX and Reflotron was 150.04±38.9 and 167.7±40.3 respectively, the difference between the reading of the two apparatuses was not statistically significant in both Urea and cholesterol.

Table (2): Mean Percent of change between Reflotron and Dimension RXI MAX test in urea and cholesterol


Mean percent of change

Total cholesterol (mg/dl)


Urea (mg/dl)


Table 2 shows that the mean percent of change between Reflotron and Dimension RXI MAX test in urea and cholesterol was -0.4% and 12.5% respectively


The Reflotron has been marketed aggressively for use in community screening programs. The marketing has focused heavily on the instrument’s relatively low cost, ease of operation, and accuracy. This strategy has resulted in the widespread use of this instrument in blood cholesterol screenings. The Reflotron has been studied previously using various settings, sample sizes, and methodologies (10).

This study compared the same blood sample using dry chemistry by the portable analyzer Reflotron plus and wet chemistry by Dimension RXI MAX apparatus.

The MultiCare systems are pocket-sized reflectance photometers, in which the intensity of the color developed from a chromogen reaction being proportional to the concentration of the cholesterol or urea in the blood. The results of the MultiCare method compared with the reference method demonstrated good agreement between the 2 methods, the difference between the reading of the two apparatuses was not statistically significant in both Urea and cholesterol with a mean difference of 12.5% and –0.4% for cholesterol and urea, respectively. The availability of POCT lipid monitors has increased in recent years, any POCT must be validated for bias and imprecision to ensure that appropriate medical decisions and population screenings are made (11-17). The National Cholesterol Education Program (NCEP) in the United States recommended bias goals of 3% and 5% for cholesterol and triglycerides, respectively.

Conclusion: The portable analyzer Reflotron provided clinically relevant underestimations of total cholesterol values comparison with Dimension RXI MAX, whereas, urea values urea values satisfied. Consequently, lipid values obtained using the Reflotron may be useful for screening, but the Reflotron should not be used as a diagnostic tool. Urea values useful for screening and diagnosis kidney diseases



  1. U.S. Department of Health and Human Services, National institutes of Health. Point-of-Care Diagnostic Testing Fact Sheet. Jul 2007.
  2. Birkhahn RH, Haines E, Wen W, Reddy L, Briggs WM, Datillo PA (2011). Estimating the clinical impact of bringing a multimarker cardiac panel to the bedside in the ED. Am J Emerg Med, 29(3):304-8.
  3. Havas, Stephen; Bishop, Robert; et al Performance of the Reflotron in Massachusetts Model System for blood cholesterol screening program. American journal of public health; Mar 1992;82,3, ProQuist central.
  4. Davis, C.L., Harmon, W.E., Himmelfarb, J., Hostetter, T., Powe, N., Smedberg, P., Szczech, L.A. and Aronson, P.S. 2008: World Kidney Day 2008: think globally, speak locally. Journal of the American Society of Nephrology 19, 413–16.
  5. Sullivan DR. Screening for cardiovascular disease with cholesterol. Int J Clin Chem 2002;315:49–60.
  6. State-specific cholesterol screening trends-United States, 1991–1999. MMWR Morb Mortal Wkly Rep 2000;284: p. 1374–5.
  7. Cheng AY, Leiter LA. (2006). Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Curr Opin Cardiol 21(4):400–404.
  8. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001).Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497.
  9. Volles DF, McKenney JM, Miller WG, Ruffen D, Zhang D. Ana- lytic and clinical performance of two compact cholesterol-testing devices. Pharmacotherapy 1998;18:184–92.
  10. Havas S, Bishop R, Koumjian L, Reisman J, Wozenski S.Performance of the Reflotron in Massachusetts’ model system for blood cholesterol measurement. Am J Public

Health 1992;82:458–61.

  1. Shephard MD, Mazzachi BC, Shephard AK. Comparative perfor- mance of two point-of-care analysers for lipid testing. Clin Lab 2007;53:561–6.
  2. Stein JH, Carlsson CM, Papcke-Benson K, Einerson JA, McBride PE, Wiebe DA. Inaccuracy of lipid measurements with the portable Cholestech L.D.X analyzer in patients with hypercho- lesterolemia. Clin Chem 2002;48:284–90.
  3. du Plessis M, Ubbink JB, Vermaak WJ. Analytical quality of near- patient blood cholesterol and glucose determinations. Clin Chem 2000;46:1085–90.
  4. Gottschling HD, Reuter W, Ronquist G, Steinmetz A, Hattemer A. Multicentre evaluation of a non-wipe system for the rapid determination of total cholesterol in capillary blood, Accutrend Cholesterol on Accutrend GC. Eur J Clin Chem Clin Biochem 1995;33:373–81.
  5. Laboratory Standardization Panel of the National Cholesterol Education Program. Current status of blood cholesterol measurement in clinical laboratories in the United States: a report from the Laboratory Standardization Panel of the National Cholesterol Education Program. Clin Chem 1988;34:193–201.
  6. Carey M, Markham C, Gaffney P, Boran C, Maher V. Validation of a point of care lipid analyser using a hospital based reference laboratory. Ir J Med Sci 2006;175:30–5.
  7. Luley C, Ronquist G, Reuter W, et al. Point-of-care testing of triglycerides: evaluation of the Accutrend triglycerides system. Clin Chem 2000;46:287–91.


Cite This Work

To export a reference to this article please select a referencing stye below:

Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.
Reference Copied to Clipboard.

Related Services

View all

DMCA / Removal Request

If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: