The Diabetes Technology Society Error Grid and Trend Accuracy Matrix for Glucose Monitors.
INTRODUCTION: An error grid compares measured versus reference glucose concentrations to assign clinical risk values to observed errors. Widely used error grids for blood glucose monitors (BGMs) have limited value because they do not also reflect clinical accuracy of continuous glucose monitors (CGMs). METHODS: Diabetes Technology Society (DTS) convened 89 international experts in glucose monitoring to (1) smooth the borders of the Surveillance Error Grid (SEG) zones and create a user-friendly tool-the DTS Error Grid; (2) define five risk zones of clinical point accuracy (A-E) to be identical for BGMs and CGMs; (3) determine a relationship between DTS Error Grid percent in Zone A and mean absolute relative difference (MARD) from analyzing 22 BGM and nine CGM accuracy studies; and (4) create trend risk categories (1-5) for CGM trend accuracy. RESULTS: The DTS Error Grid for point accuracy contains five risk zones (A-E) with straight-line borders that can be applied to both BGM and CGM accuracy data. In a data set combining point accuracy data from 18 BGMs, 2.6% of total data pairs equally moved from Zones A to B and vice versa (SEG compared with DTS Error Grid). For every 1% increase in percent data in Zone A, the MARD decreased by approximately 0.33%. We also created a DTS Trend Accuracy Matrix with five trend risk categories (1-5) for CGM-reported trend indicators compared with reference trends calculated from reference glucose. CONCLUSION: The DTS Error Grid combines contemporary clinician input regarding clinical point accuracy for BGMs and CGMs. The DTS Trend Accuracy Matrix assesses accuracy of CGM trend indicators.
Authors
- Anne L. Peters (ORCID: https://orcid.org/0000-0003-0520-0776)
- Nicole L. Spartano (ORCID: https://orcid.org/0000-0002-0724-8629)
- G. Alexander Fleming (ORCID: https://orcid.org/0000-0002-6549-0288)
- Signe Schmidt (ORCID: https://orcid.org/0000-0002-6968-6675)
- Julia E. Blanchette (ORCID: https://orcid.org/0000-0002-6714-4792)
- Chhavi Mehta (ORCID: https://orcid.org/0000-0003-0223-5009)
- Kathleen Marie Dungan (ORCID: https://orcid.org/0000-0003-1289-1595)
- Mônica Andrade Lima Gabbay (ORCID: https://orcid.org/0000-0002-1300-9675)
- Bin Sheng (ORCID: https://orcid.org/0000-0001-8678-2784)
- Wei-An Lee (ORCID: https://orcid.org/0000-0002-2928-7338)
- Chris Worth (ORCID: https://orcid.org/0000-0001-6609-2735)
- Sufyan Hussain (ORCID: https://orcid.org/0000-0001-6611-8245)
- Sang Youl Rhee (ORCID: https://orcid.org/0000-0003-0119-5818)
- Juan Espinoza (ORCID: https://orcid.org/0000-0003-0513-588X)
- Sewagegn Yeshiwas (ORCID: https://orcid.org/0000-0002-8153-7672)
- Jan S. Krouwer (ORCID: https://orcid.org/0000-0003-2300-076X)
- Michael A. Kohn (ORCID: https://orcid.org/0000-0001-5459-5044)
- David B. Sacks (ORCID: https://orcid.org/0000-0003-3100-0735)
- Halis Kaan Aktürk (ORCID: https://orcid.org/0000-0003-4518-5179)
- Michael S. D. Agus (ORCID: https://orcid.org/0000-0001-6454-6828)
- Lia Bally (ORCID: https://orcid.org/0000-0003-1993-7672)
- Gregg D. Simonson (ORCID: https://orcid.org/0000-0001-5561-2547)
- Rodica Pop‐Busui (ORCID: https://orcid.org/0000-0002-2042-1350)
- James H. Nichols (ORCID: https://orcid.org/0000-0002-3652-1612)
- Rayhan Lal (ORCID: https://orcid.org/0000-0002-8055-944X)
- Andreas Pfützner (ORCID: https://orcid.org/0000-0003-2385-0887)
- Rodolfo Javier Galindo (ORCID: https://orcid.org/0000-0002-9295-3225)
- Viral N. Shah (ORCID: https://orcid.org/0000-0002-3827-7107)
- Matt Baker (ORCID: https://orcid.org/0000-0001-9241-6836)
- Raveendhara R. Bannuru (ORCID: https://orcid.org/0000-0002-8069-5783)
- Mark A. Clements (ORCID: https://orcid.org/0000-0002-2368-0331)
- Ana María Gómez Medina (ORCID: https://orcid.org/0000-0002-8907-3470)
- Shivani Misra (ORCID: https://orcid.org/0000-0003-2886-0726)
- Koji Sode (ORCID: https://orcid.org/0000-0002-9833-2091)
- Stefan Pleus (ORCID: https://orcid.org/0000-0003-4629-7754)
- Kong Y. Chen (ORCID: https://orcid.org/0000-0002-0306-1904)
- Shashank Joshi (ORCID: https://orcid.org/0000-0002-0990-5821)
- Julia Katharina Mader (ORCID: https://orcid.org/0000-0001-7854-4233)
- Niels Ejskjær (ORCID: https://orcid.org/0000-0003-3749-3403)
- Tiffany Tian (ORCID: https://orcid.org/0009-0003-1417-6445)
- David Kerr (ORCID: https://orcid.org/0000-0003-1335-1857)
- Connie M. Rhee (ORCID: https://orcid.org/0000-0002-9703-6469)
- Eda Cengiz (ORCID: https://orcid.org/0000-0001-7992-9506)
- Maryam Vareth
- Marcus Lind (ORCID: https://orcid.org/0000-0002-3796-9283)
- Chiara Fabris (ORCID: https://orcid.org/0000-0001-7575-4622)
- Barbora Voglová Hagerf (ORCID: https://orcid.org/0000-0001-7132-5134)
- Michael J. McShane (ORCID: https://orcid.org/0000-0001-6838-3982)
- Gerard L. Coté (ORCID: https://orcid.org/0000-0002-3164-9625)
- Peter G. Jacobs (ORCID: https://orcid.org/0000-0001-9897-4783)
- Nestoras Mathioudakis (ORCID: https://orcid.org/0000-0002-0210-655X)
- J. Geoffrey Chase (ORCID: https://orcid.org/0000-0001-9989-4849)
- David Norman O'Neal (ORCID: https://orcid.org/0000-0002-0870-4032)
- Timothy S. Bailey (ORCID: https://orcid.org/0000-0003-4178-3462)
- Jane Jeffrie Seley (ORCID: https://orcid.org/0000-0003-1582-4320)
- Eugene E. Wright (ORCID: https://orcid.org/0000-0003-0796-0496)
- Umesh Masharani (ORCID: https://orcid.org/0000-0002-3269-804X)
- Mihail Zilbermint (ORCID: https://orcid.org/0000-0003-4047-7260)
- Yong Mong Bee (ORCID: https://orcid.org/0000-0002-5482-2646)
- Francisco J. Pasquel (ORCID: https://orcid.org/0000-0002-3845-6703)
- Amanda Adler (ORCID: https://orcid.org/0000-0002-2797-3385)
- David T. Ahn (ORCID: https://orcid.org/0000-0002-8941-8459)
- Lutz Heinemann (ORCID: https://orcid.org/0000-0003-2493-1304)
- Hubert W. Vesper (ORCID: https://orcid.org/0000-0002-9649-9015)
- Mohammed E. Al‐Sofiani (ORCID: https://orcid.org/0000-0003-4420-9378)
- Ashutosh Sabharwal (ORCID: https://orcid.org/0000-0003-1898-5787)
- JOHAN H. JENDLE (ORCID: https://orcid.org/0000-0003-1025-1682)
- Boris P. Kovatchev (ORCID: https://orcid.org/0000-0003-0495-3901)
- Kayo Waki (ORCID: https://orcid.org/0000-0003-0046-2523)
- Ketan Dhatariya (ORCID: https://orcid.org/0000-0003-3619-9579)
- Alan H.B. Wu (ORCID: https://orcid.org/0000-0002-5610-2036)
- Norbert Hermanns (ORCID: https://orcid.org/0000-0002-2903-2677)
- Lawrence A. Leiter (ORCID: https://orcid.org/0000-0002-1040-6229)
- Elias K. Spanakis (ORCID: https://orcid.org/0000-0002-9352-7172)
- Nam K. Tran (ORCID: https://orcid.org/0000-0003-1565-0025)
- Keetan Rutledge (ORCID: https://orcid.org/0000-0001-6394-8358)
- Thanh D. Hoang (ORCID: https://orcid.org/0000-0001-7437-5604)
- Andjela Drincic (ORCID: https://orcid.org/0000-0001-8365-7662)
- Guido Freckmann (ORCID: https://orcid.org/0000-0002-0406-9529)
- David Charles Klonoff (ORCID: https://orcid.org/0000-0001-6394-6862)
- Alberto Maran (ORCID: https://orcid.org/0000-0002-7266-8486)
- Sun Joon Moon (ORCID: https://orcid.org/0000-0002-6286-7254)
- Suneil K. Koliwad (ORCID: https://orcid.org/0000-0002-7367-1054)
- Daniel R. Cherñavvsky (ORCID: https://orcid.org/0000-0001-7395-1841)
- Elizabeth M Bauer (ORCID: https://orcid.org/0000-0002-7474-4462)
- Rachel E. Aaron (ORCID: https://orcid.org/0009-0005-5120-2264)
- Jing Wang (ORCID: https://orcid.org/0000-0002-4012-0977)
- Chengdong Li (ORCID: https://orcid.org/0000-0001-5330-9624)
- Guillermo E Umpierrez
- Pratistha Ranjitkar (ORCID: https://orcid.org/0000-0002-1431-1868)
- Simon M. Schwaighofer (ORCID: https://orcid.org/0009-0006-9984-1556)
- Cindy Ho (ORCID: https://orcid.org/0009-0008-3067-1004)
- Alessandra T. Ayers
- Chui Ying Tse
Institutions
- University of North Carolina at Chapel Hill (US)
Publication Details
- Journal
- UNC Libraries
- Published
- 2024-10-17
- DOI
- https://doi.org/10.17615/ne2z-1491
- Primary Topic
- Diabetes Management and Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Science Foundation
- U.S. Department of Defense
- U.S. Department of Health and Human Services
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Leona M. and Harry B. Helmsley Charitable Trust
- Wellcome Trust
- Insulet Corporation
- MannKind Corporation
- Dexcom
- Cardinal Health
- Tandem Diabetes Care
- National Institute for Health and Care Research
- Novo Nordisk
- Roche Diabetes Care
- Centers for Disease Control and Prevention
- University of California, Davis
- Abbott Diabetes Care
- NIHR Imperial Biomedical Research Centre
- Agency for Toxic Substances and Disease Registry