Accessible Unlicensed Requires Authentication Published by De Gruyter September 21, 2011

Comparison of TEST 1 with SRS 100 and ICSH reference method for the measurement of the length of sedimentation reaction in blood

Sebahat Ozdem, Halide S. Akbas, Levent Donmez and Meral Gultekin


Background: We evaluated the measurement of length of sedimentation reaction in blood (LSRB) by TEST 1 and compared the results with those for the Westergren and Sed Rate Screener 100 (SRS 100) methods.

Methods: LSRB was measured in 113 paired blood samples.

Results: TEST 1 correlated significantly with the Westergren (r=0.94) and SRS 100 (r=0.90) methods with low bias (−0.29 and −1.92mm/h, respectively) and limits of agreement (−14.5 to 13.9, and −23.4 to 19.6mm/h, respectively). Hematocrit (Htc) correlated negatively with LSRB in TEST 1 (r=−0.54) and SRS 100 (r=−0.53) only in samples with high Htc (≥35%). The bias and limits of agreement between TEST 1 and Westergren in samples with low (−1.46 and −22.3 to 19.3mm/h) and high (0.43 and −7.29 to 8.14mm/h) Htc were comparable to those between SRS 100 and Westergren (1.83 and −27.2 to 30.9mm/h for low, 0.71 and −7.27 to 8.70mm/h for high Htc samples). Total protein and fibrinogen correlated similarly with LSRB in both TEST 1 (r=0.23 and 0.48, respectively) and SRS 100 (r=0.30 and 0.51, respectively).

Conclusions: The findings suggested that TEST 1 is a reliable, precise and accurate system for measurement of LSRB in clinical laboratories with high workload.

Corresponding author: Sebahat Ozdem, Akdeniz University, Medical Faculty, Central Laboratory, Clinical Biochemistry Unit, Arapsuyu 07070, Antalya, Turkey Phone: +90-242-2274343 ext 33252, Fax: +90-242-2272535,


1. International Council for Standardization in Haematology. ICSH recommendations for measurement of erythrocyte sedimentation rate. J Clin Pathol 1993;46:198–203.Search in Google Scholar

2. Sox HC, Liang MH. The erythrocyte sedimentation rate. Ann Intern Med 1986; 4:515–23.Search in Google Scholar

3. Wolfe F, Michaud K. The clinical and research significance of the erythrocyte sedimentation rate. J Rheumatol 1994; 21:1177–8.Search in Google Scholar

4. Westergren A. Studies of the suspension stability of the blood in pulmonary tuberculosis. Acta Med Scan 1921; 54:247–82.Search in Google Scholar

5. National Committee for Clinical Laboratory Standards. Reference and selected procedure for erythrocyte sedimentation rate (ESR) test. Approved standard, 4th ed. H2-A4. Villanova, PA: NCCLS, 2000.Search in Google Scholar

6. Patton WN, Meyer PJ, Stuart J. Evaluation of sealed vacuum extraction method (Seditainer) for measurement of erythrocyte sedimentation rate. J Clin Pathol 1989; 42:313–7.Search in Google Scholar

7. Plebani M, De Toni S, Sanzari MC, Bernardi D, Stockreiter E. The TEST1 automated system: a new method for measuring the erythrocyte sedimentation rate. Am J Clin Pathol 1998; 110:334–40.Search in Google Scholar

8. Bland JM, Altman DG. Statistical method for assessing agreement between two methods of clinical measurement. Lancet 1986; 1:307–10.Search in Google Scholar

9. Plebani M. Erythrocyte sedimentation rate: innovative techniques for an obsolete test? Clin Chem Lab Med 2003; 41:115–6.Search in Google Scholar

10. Romero A, Munoz M, Ramirez G. Length of sedimentation reaction in blood: a comparison of the Test 1 ESR system with the ICSH reference method and the Sedisystem 15. Clin Chem Lab Med 2003; 41:232–7.Search in Google Scholar

11. de Jonge N, Sewkaransing I, Slinger J, Rijsdijk JJ. Erythrocyte sedimentation rate by the Test-1 analyzer. Clin Chem 2000; 46:881–2.Search in Google Scholar

12. Plebani M, Piva E. Erythrocyte sedimentation rate. Use of fresh blood for quality control. Am J Clin Pathol 2002; 117:621–6.Search in Google Scholar

13. Giavarina D, Dall'Olio G, Soffiati G. Method comparison of automated systems for the erythrocyte sedimentation rate. Am J Clin Pathol 1999; 112:721–2.Search in Google Scholar

14. Arezzini C, Ricci A. Method comparison of automated systems for the erythrocyte sedimentation rate – more study needed. Am J Clin Pathol 1999; 112:722–4.Search in Google Scholar

15. Fabry TL. Mechanism of erythrocyte aggregation and sedimentation. Blood 1987; 70:1572–6.Search in Google Scholar

16. Bedell SE, Bush BT. Erythrocyte sedimentation rate, from folklore to facts. Am J Med 1985; 78:1001–9.Search in Google Scholar

17. Ballou SP, Kushner I. Laboratory evaluation of inflammation. In: Kelly W, Harris E, Ruddy S, Sledge C, editors. Textbook of rheumatology, 5th ed. Philadelphia, PA: Saunders, 1996:699–706.Search in Google Scholar

18. Hung WT, Collings AF, Low J. Erythrocyte sedimentation rate studies in whole human blood. Phys Med Biol 1994; 39:1855–73.Search in Google Scholar

19. Piva E, Sanzari MC, Servidio G, Plebani M. Length of sedimentation reaction in undiluted blood (erythrocyte sedimentation rate): variations with sex and age and reference limits. Clin Chem Lab Med 2001; 39:451–4.Search in Google Scholar

20. Horsti J, Kovanen M. Using EDTA as an anticoagulant for ESR to replace citrate. Klin Lab 2000; 4:97–100.Search in Google Scholar

21. Koepke JA, van Assendelft OW, Bull BS, Richardson-Jones A. Standardization of EDTA anticoagulation of blood counting procedures. Labmedica 1989; 5:15–7.Search in Google Scholar

Received: 2005-11-30
Accepted: 2006-1-4
Published Online: 2011-9-21
Published in Print: 2006-4-1

©2006 by Walter de Gruyter Berlin New York