Point-of-care hemoglobin meters show high sensitivity but lower specificity versus analyzer in Ghanaian studyStudy finds portable anemia meters may underestimate hemoglobin levels compared to lab tests

medRxiv Published April 6, 2026 Study authors: Amankwaah, L.; Acheampong, G. A. DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Interpret point-of-care hemoglobin meter results cautiously due to underestimation and low specificity versus analyzers.

This cross-sectional study evaluated 100 participants who visited the laboratory for complete blood count at Aniniwaa Medical Centre in Kumasi, Ghana. Researchers compared hemoglobin measurements from two point-of-care devices (Urit and Mission) against a fully automated hematology analyzer as the reference standard.

The prevalence of anemia varied substantially across methods: 28% by the analyzer, 60% by the Urit meter, and 64% by the Mission meter. Both point-of-care devices demonstrated 100% sensitivity for detecting anemia but had low specificity (55.6% for Urit and 50.0% for Mission). Compared to the analyzer, both meters showed negative biases: Urit underestimated hemoglobin by 1.665 g/dL and Mission by 1.55 g/dL.

No safety or tolerability data were reported for the devices. Key limitations include the single-center design, lack of reported confidence intervals or p-values for the findings, and absence of information about funding or conflicts of interest. The study did not report primary or secondary outcomes explicitly.

For clinical practice, these findings suggest that while point-of-care hemoglobin meters offer convenience and portability for field screening, they systematically underestimate hemoglobin values and have concerningly low specificity. The automated hematology analyzer remains more accurate and reliable for definitive anemia diagnosis in clinical settings. Clinicians should interpret point-of-care hemoglobin results cautiously, particularly when values are near diagnostic thresholds.

Researchers in Ghana wanted to see how well two portable hemoglobin meters worked compared to a standard lab machine. They tested 100 people who visited a medical center for blood work. The portable devices (Urit and Mission) were checked against a fully automated hematology analyzer, which is the more accurate tool doctors typically use in clinics.

The study found that the portable meters were very good at catching people who had anemia—they identified every single case. However, they also frequently said healthy people had anemia when they didn't. Both portable devices gave hemoglobin readings that were about 1.5 to 1.7 grams per deciliter lower than the lab machine, meaning they underestimated the actual level.

No safety issues were reported, as this was just a measurement comparison. The main reason to be careful is that these portable meters, while convenient for quick checks in the field, are not as precise as lab equipment. For now, readers should understand that if a portable meter suggests anemia, it should be followed up with a proper lab test for an accurate diagnosis.

What this means for you:

Portable anemia meters are good for screening but may need confirmation with a lab test.

Study Details

Sample sizen = 100

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

IntroductionAnaemia is one of the most prevalent global public health challenges, particularly among women of reproductive age and children. According to the World Health Organization, anaemia is defined as a hemoglobin concentration below 13.0 g/dL in adult men, 12.0 g/dL in non-pregnant women, and 11.0 g/dL in pregnant women. Hemoglobin measurement therefore plays a critical role in diagnosis, classification, and monitoring of anaemia at both clinical and public health levels. Hemoglobin estimation allows early identification and intervention in at-risk populations. MethodologyA cross-sectional study was conducted at Aniniwaa Medical Centre, Kumasi, involving 100 participants who visited the laboratory for a complete blood count. Venous blood samples were collected aseptically into EDTA tubes and analysed first with the fully automated analyser, followed by the two Hb meters. Data were analysed using Chi-square tests, Bland-Altman plots, and descriptive statistics. ResultsResults showed that the prevalence of anaemia varied across methods: 28% by the analyser, 60% by Urit, and 64% by Mission. Both meters demonstrated 100% sensitivity but lower specificities (55.6% for Urit and 50.0% for Mission). Bland-Altman analysis indicated negative biases (Urit = -1.665 g/dL; Mission = -1.55 g/dL), suggesting both underestimated hemoglobin values compared to the reference. ConclusionThe study revealed that while Hb meters offer convenience and portability for field screening, the fully automated analyser remains more accurate and reliable for diagnosing anaemia in clinical settings.

Point-of-care hemoglobin meters show high sensitivity but lower specificity versus analyzer in Ghanaian studyStudy finds portable anemia meters may underestimate hemoglobin levels compared to lab tests

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Point-of-care hemoglobin meters show high sensitivity but lower specificity versus analyzer in Ghanaian studyStudy finds portable anemia meters may underestimate hemoglobin levels compared to lab tests

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