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2016 ; 68
(7
): 1751-7
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A Point-of-Care Raman Spectroscopy-Based Device for the Diagnosis of Gout and
Pseudogout: Comparison With the Clinical Standard Microscopy
#MMPMID26882173
Li B
; Singer NG
; Yeni YN
; Haggins DG
; Barnboym E
; Oravec D
; Lewis S
; Akkus O
Arthritis Rheumatol
2016[Jul]; 68
(7
): 1751-7
PMID26882173
show ga
OBJECTIVE: To demonstrate the usefulness of a novel medical device based on Raman
spectroscopy for the rapid point-of-care diagnosis of gout and pseudogout.
METHODS: A shoebox-sized point-of-care Raman spectroscopy (POCRS) device was
developed for use in the diagnosis of gout and pseudogout. The device included a
disposable syringe microfiltration kit to collect arthropathic crystals from
synovial fluid and a customized automated Raman spectroscopy system to chemically
identify crystal species. Diagnosis according to the findings of POCRS was
compared with the clinical standard diagnosis based on compensated polarized
light microscopy (CPLM) of synovial fluid aspirates collected from symptomatic
patients (n?=?174). Kappa coefficients were used to measure the agreement between
POCRS and CPLM findings. RESULTS: Overall, POCRS and CPLM results were consistent
in 89.7% of samples (156 of 174). For the diagnosis of gout, the kappa
coefficient for POCRS and CPLM was 0.84 (95% confidence interval [95% CI]
0.75-0.94). For the diagnosis of pseudogout, the kappa coefficient for POCRS and
CPLM was 0.61 (95% CI 0.42-0.81). CONCLUSION: Kappa coefficients indicated that
there was excellent agreement between POCRS and CPLM for the diagnosis of gout,
with good agreement for the diagnosis of pseudogout. The POCRS device holds the
potential to standardize and expedite the time to clinical diagnosis of gout and
pseudogout, especially in settings where certified operators trained for CPLM
analysis are not available.