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Can we use Point of Care HbA1c Testing (POCT) to diagnose type 2 diabetes? (EnglishEU18SF)

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  • Full or part time
    Dr E English
  • Application Deadline
    No more applications being accepted
  • Self-Funded PhD Students Only
    Self-Funded PhD Students Only

Project Description

Currently type 2 diabetes can be diagnosed using glucose or HbA1c testing provided that stringent quality assurance tests are in place. In many countries only laboratory methods are considered to be good enough to meet these criteria however, there is considerable debate as to whether Point of Care Testing (POCT) devices for HbA1c could also be used to diagnose type 2 diabetes. Analytical quality studies have provided mixed results and are most commonly performed by laboratory staff under evaluation conditions. This mixed methods project will look at the core factors that need to be addressed to ascertain if POC HbA1c can be used to diagnose type 2 diabetes. The first element is an analytical quality study in the setting of the diabetes clinic and undertaken by non-laboratory personnel. This will demonstrate how these devices perform in real life settings rather than laboratory evaluations. A second element will be to assess the usability and acceptability of these devices in primary care settings. This will address the barriers and facilitators to the use of HbA1c devices and also assess the knowledge and understanding of Health Care Professionals in relation to HbA1c testing. The final element would be to develop and trial a quality framework for POCT HbA1c in low resource settings such as rural Africa or China. Areas that do not have easy access to laboratory services present a unique challenge to diagnosing diabetes and would potentially benefit from structured testing programmes using HbA1c POCT devices. This project offers training in a diverse range of research and transferable skills.


For more information on the supervisor for this project, please go here: https://people.uea.ac.uk/en/persons/emma-english

The type of programme: PHD

Project Start Date: 2018/19

Full-time or Part-time

- Entry Requirements: This project is suitable for someone with a good first degree (at least 2:1) in a related topic area, such as Medicine, laboratory science, health sciences.

The standard minimum entry requirement is 2:1


Funding Notes

This PhD project is offered on a self-funding basis. It is open to applicants with funding or those applying to funding sources. Details of tuition fees can be found at http://www.uea.ac.uk/study/postgraduate/research-degrees/fees-and-funding

References

i) Sølvik UØ, Røraas T, Christensen NG, Sandberg S. Diagnosing diabetes mellitus:
performance of hemoglobin A1c point-of-care instruments in general practice
offices. Clin Chem. 2013 Dec;59(12):1790-801. doi: 10.1373/clinchem.2013.210781.

ii) Hirst JA, McLellan JH, Price CP, English E, Feakins BG, Stevens RJ, Farmer AJ.
Performance of point-of-care HbA1c test devices: implications for use in clinical
practice - a systematic review and meta-analysis. Clin Chem Lab Med. 2017 Feb
1;55(2):167-180. doi: 10.1515/cclm-2016-0303

iii) Al-Ansary L, Farmer A, Hirst J, Roberts N, Glasziou P, Perera R, Price CP.
Point-of-care testing for Hb A1c in the management of diabetes: a systematic
review and metaanalysis. Clin Chem. 2011 Apr;57(4):568-76. doi:
10.1373/clinchem.2010.157586.
iv) https://www.oxford.dec.nihr.ac.uk/reports-and-resources/horizon-scanning-reports/point-of-care-hba1c-tests-diagnosis-of-diabetes
v) https://www.england.nhs.uk/wp-content/uploads/2016/07/poct-paper.pdf



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