journal article Open Access May 19, 2025

Equivalence between Capillary Blood and Venous Blood Test Results Using Miniaturized Assays and Novel Collection Methods to Support Routine Bloodwork

View at Publisher Save 10.1093/jalm/jfaf059
Abstract
Abstract

Background
Capillary blood testing has potential to improve accessibility and adherence for routine tests. Due to historical challenges with sample volume and quality, capillary blood is rarely used for diagnostic testing. These studies provide objective evidence that miniaturized assays and novel capillary collection technologies can enable equivalent results for important panels.


Methods
The studies evaluated equivalence of capillary blood testing using miniaturized assays and novel collection methods. We verified the performance of 20 miniaturized assays vs their unmodified versions. We then evaluated specimen equivalence across 39 analytes by comparing samples collected with novel capillary technologies vs samples collected with conventional technologies. For 38 analytes, specimen equivalence was evaluated vs conventional venous samples, and vs conventional capillary samples for 2 analytes with biological gradients (glucose and total CO2).


Results
Equivalence of miniaturized assays and novel capillary methods to conventional testing was demonstrated across all analytes. Method comparison of all 20 miniaturized assays highly correlated (Pearson r > 0.95) to unmodified versions of each test. Capillary blood collected with the novel collection procedure produced results equivalent to conventional methods, with 37 analytes performing equivalently to venous serum, glucose to both venous and conventional capillary serum, and total CO2 to conventional capillary serum.


Conclusions
Capillary blood can be utilized for routine bloodwork. Issues with sample volume can be overcome by miniaturizing assays without compromising performance. Issues with sample quality can be overcome by novel capillary collection technologies, which additionally enable non-phlebotomist sample collection in a broad scope of healthcare settings.
Topics

No keywords indexed for this article. Browse by subject →

References
39
[1]
BD
[2]
Galena "Complications occurring from diagnostic venipuncture" J Fam Pract (1992)
[3]
Tang "Capillary blood for point-of-care testing" Crit Rev Clin Lab Sci (2017) 10.1080/10408363.2017.1343796
[4]
Novis "Laboratory staff turnover: a College of American Pathologists Q-Probes Study of 23 clinical laboratories" Arch Pathol Lab Med (2020) 10.5858/arpa.2019-0140-cp
[5]
Silber "SA13: utilization of bloodwork and routine medical visits in the US General Population: analysis of the optum claims data [Abstract]" Value Health (2022) 10.1016/j.jval.2022.04.1679
[6]
Stevenson "Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation" Health Technol Assess (2012) 10.3310/hta16040
[7]
Reid (2010)
[8]
Nwankwo "Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study" BMJ Open Qual (2021) 10.1136/bmjoq-2020-001192
[9]
El-Abd "The accuracy of capillary blood glucose testing versus real time and intermittently scanned continuous glucose monitoring" Pract Diabetes (2023) 10.1002/pdi.2479
[10]
Bond "Drop-to-drop variation in the cellular components of fingerprick blood: implications for point-of-care diagnostic development" Am J Clin Pathol (2015) 10.1309/ajcp1l7dkmpchpeh
[11]
Cao "Validation of capillary blood analysis and capillary testing mode on the epoc Point of Care system" Pract Lab Med (2017) 10.1016/j.plabm.2017.07.003
[12]
Dong "First versus second drop of capillary blood for monitoring blood glucose: a meta-analysis and systematic review" Arch Med Sci (2024)
[13]
Haymarket Medical Network
[14]
Pourafshar "An assessment of individual preference for a novel capillary blood collection system" Patient Prefer Adherence (2024) 10.2147/ppa.s437969
[15]
Healthcare Insights
[16]
CLSI (2020)
[17]
CLSI (2012)
[18]
CLSI (2014)
[19]
CLSI (2018)
[20]
CLSI (2019)
[21]
CLSI (2018)
[22]
CLSI (2018)
[23]
CLSI (2016)
[24]
CLSI (2008)
[25]
CLSI (2010)
[26]
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS) "493.1253 standard: establishment and verification of performance specifications" Fed Regist (2023)
[27]
Food and Drug Administration (FDA), Department of Health and Human Services (HHS) "Medical devices; laboratory developed tests" Fed Regist Final Rule (2024)
[28]
CLSI (2017)
[29]
CLSI (2008)
[30]
Olson
[31]
Olson
[32]
Olson
[33]
Westgard (2006)
[34]
Verran "Investigative algorithms for disorder affecting plasma bilirubin: a narrative review" J Lab Precis Med (2024) 10.21037/jlpm-23-24
[35]
NACB (2002)
[36]
Somogyi "Studies of arteriovenous differences in blood sugar: I. Effect of alimentary hyperglycemia on the rate of extrahepatic glucose assimilation" J Biol Chem (1948) 10.1016/s0021-9258(18)57386-5
[37]
Lebeck "Plasma glycerol levels in men with hypertriglyceridemia" Scand J Clin Lab Invest (2021) 10.1080/00365513.2021.1904282
[38]
Doeleman "Comparison of capillary finger stick and venous blood sampling for 34 routine chemistry analytes: potential for in hospital and remote blood sampling" Clin Chem Lab Med (2025) 10.1515/cclm-2024-0812
[39]
Lippi "Influence of hemolysis on routine clinical chemistry testing" Clin Chem Lab Med (2006) 10.1515/cclm.2006.054