This application is generally directed to the field of measurement systems and more specifically to a system and related method for measurement of analytes such as glucose.
Demand continues for low cost, accurate and easy to use diagnostics systems that allow patients and clinicians to measure and monitor a wide variety of analytes and physiological factors. Systems that allow the accurate, safe and cost effective measurement of analytes or physiological blood based properties relating to common health conditions are of particular interest. Examples of such analytes and blood properties include glucose, cholesterol, blood ketones, hematocrit, numerous cardiac health bio markers and blood clotting time. While numerous examples of such diagnostic devices are known, the cost and accuracy of such devices remains of significant concern to patients, insurers and health care professionals alike.
By way of example, the determination of blood analyte concentration is typically performed by means of an episodic measuring device such as a hand-held electronic meter which receives blood samples via enzyme-based test strips and calculates the blood analyte value based on the enzymatic reaction. In some diagnostic devices the test sample viscosity or rate at which a species diffuses are of interest because variations in sample viscosity/diffusion may affect the accuracy of the measurement. For example, in common episodic electrochemical glucose test strip results hematocrit impacts the ability of reactive species to diffuse through the analyte thereby impacting measured response. Information as to the rate of diffusion or viscosity would allow compensation for this effect. In other diagnostic assays the rate at which a species of interest diffuses through the test sample may be indicative of the progression of important integrations between certain reagents and the test sample, such as in certain types of immunoassays. In all of the above cases the ability to simply, accurately and cost effectively measure the rate at which a species of interest diffuses through the test sample would provide an indication of viscosity/diffusion and therefore may be important in calculating the concentration of an analyte.
So that the manner in which the features of the invention can be understood, a detailed description of the invention may be had by reference to certain embodiments, some of which are illustrated in the accompanying drawings. It is to be noted, however, that the drawings illustrate only certain embodiments of this invention and are therefore not to be considered limiting of its scope, for the scope of the disclosed subject matter encompasses other embodiments as well. The drawings are not necessarily to scale, emphasis generally being placed upon illustrating the features of certain embodiments of the invention. In the drawings, like numerals are used to indicate like parts throughout the various views.
The following Detailed Description should be read with reference to the drawings, in which like elements in different drawings are identically numbered. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. The Detailed Description illustrates by way of example, not by way of limitation, the principles of the invention. This description will clearly enable one skilled in the art to make and use the invention, and describes several embodiments, adaptations, variations, alternatives and uses of the invention, including what is presently believed to be the best mode of carrying out the invention.
As used herein, the terms “about” or “approximately” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein. In addition, as used herein, the terms “patient,” “host,” “user,” and “subject” refer to any human or animal subject and are not intended to limit the systems or methods to human use, although use of the subject techniques in a human patient represents a preferred embodiment.
The present disclosure relates, in part, to analyte measurement systems using expert systems that can select and use multiple intermediate analyte concentration calculations to provide more accurate analyte concentration measurements. Specifically, a multi-pulse waveform may be applied to a biosensor, such as a test strip, to measure the current response. The measured current values may be used to calculate an analyte concentration in multiple different ways (e.g., using multiple different equations), some of which are more accurate under certain circumstances, such as within certain ranges of analyte concentrations, at certain hematocrit levels, etc. Advantageously, the system and method disclosed herein allow for combining the multiple different calculations so that analyte concentration results are more accurate.
By way of explanation, after conducting numerous clinical trials involving large numbers of patients and comparing the results of analyte measurements taken with biosensors (e.g., test strips) with analyte measurements taken with laboratory equipment, new methods have been discovered that demonstrably improve the accuracy of the measurements. As will be explained below, the clinical trials and laboratory testing have been used to derive certain tables of coefficients and scaling factors which may be used in conjunction with an expert system to perform enhanced accuracy analyte concentration measurements.
Generally stated, provided herein, in one embodiment, is a method for determining a concentration of an analyte in a physiological fluid with a biosensor having at least two electrodes. At least three voltage pulses are applied across the two electrodes. The at least three voltage pulses include at least two pulses of opposite polarity. Current values are measured at one of the two electrodes during each of the three voltage pulses. Intermediate analyte concentrations of the analyte are calculated, including a first intermediate analyte concentration using a first subset of the measured current values and a first scaling factor, a second intermediate analyte concentration using a second subset of the measured current values and a second scaling factor, and a third intermediate analyte concentration using a third subset of the measured current values and a third scaling factor.
The first subset and the first scaling factor are selected to provide the calculated first intermediate analyte concentration with a first level of accuracy across a range of analyte concentrations ranging from a low range to a high range. The second subset and the second scaling factor are selected to provide the calculated second intermediate analyte concentration with a second level of accuracy higher than the first level of accuracy in the low range of the analyte concentrations. The third subset and the third scaling factor are selected to provide the calculated third intermediate analyte concentration with a third level of accuracy higher than the first level of accuracy in the high range of the analyte concentrations.
The concentration of the analyte is determined as a function of the first, second and third intermediate analyte concentrations. The second intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the low range. The third intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the high range. An average (or weighted average) of the second and third intermediate analyte concentrations are selected responsive to the first intermediate analyte concentration being between the low and the high ranges.
In another aspect, a method for determining a concentration of an analyte in a physiological fluid with a biosensor having at least two electrodes is presented. At least three voltage pulses are applied across the two electrodes. The at least three voltage pulses comprising at least two pulses of opposite polarity. Current values are measured at one of the two electrodes during each of the three voltage pulses. Intermediate analyte concentrations of the analyte are calculated including a first intermediate analyte concentration using a first subset of the measured current values and a first scaling factor, a second intermediate analyte concentration using a second subset of the measured current values and a second scaling factor, a third intermediate analyte concentration using a third subset of the measured current values and a third scaling factor, and a fourth intermediate analyte concentration of the analyte using at least one of the current values measured during the third voltage pulse without using a scaling factor.
The first subset and the first scaling factor are selected to provide the calculated first intermediate analyte concentration with a first level of accuracy across a range of analyte concentrations ranging from a low range to a high range. The second subset and the second scaling factor are selected to provide the calculated second intermediate analyte concentration with a second level of accuracy higher than the first level of accuracy in the low range of the analyte concentrations. The third subset and the third scaling factor are selected to provide the calculated third intermediate analyte concentration with a third level of accuracy higher than the first level of accuracy in the high range of the analyte concentrations.
Concentration of the analyte is determined as a function of the first, second and third intermediate analyte concentrations. The first intermediate analyte concentration is selected responsive to a temperature of the physiological fluid being outside a predetermined temperature range. The second intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the low range. The third intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the high range. An average (or weighted average) of the second and third intermediate analyte concentrations is selected responsive to the first intermediate analyte concentration being between the low and the high ranges. A relative bias value is calculated between the determined analyte concentration and the fourth intermediate analyte concentration. An error is reported responsive to the relative bias value being greater than a predetermined amount.
In a further aspect, a system for determining a concentration of an analyte in a physiological fluid is presented. The system includes a biosensor and a meter for performing various steps. The biosensor has at least two electrodes. At least three voltage pulses are applied across the two electrodes and measure current values. The at least three voltage pulses include at least two pulses of opposite polarity. The current values are measured at one of the two electrodes during each of the three voltage pulses.
Intermediate analyte concentrations of the analyte are calculated including a first intermediate analyte concentration using a first subset of the measured current values and a first scaling factor, a second intermediate analyte concentration using a second subset of the measured current values and a second scaling factor, and a third intermediate analyte concentration using a third subset of the measured current values and a third scaling factor.
The first subset and the first scaling factor are selected to provide the calculated first intermediate analyte concentration with a first level of accuracy across a range of analyte concentrations ranging from a low range to a high range. The second subset and the second scaling factor are selected to provide the calculated second intermediate analyte concentration with a second level of accuracy higher than the first level of accuracy in the low range of the analyte concentrations. The third subset and the third scaling factor are selected to provide the calculated third intermediate analyte concentration with a third level of accuracy higher than the first level of accuracy in the high range of the analyte concentrations.
The concentration of the analyte is determined as a function of the first, second and third intermediate analyte concentrations. The second intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the low range. The third intermediate analyte concentration is selected responsive to the first intermediate analyte concentration being in the high range. An average (or weighted average) of the second and third intermediate analyte concentrations is selected responsive to the first intermediate analyte concentration being between the low and the high ranges.
The above embodiments are intended to be merely examples. It will be readily apparent from the following discussion that other embodiments are within the scope of the disclosed subject matter.
Specific working examples will now be described. Initially, with respect to
The electrodes may be made of a material that has a low electrical resistance, such as carbon, gold, platinum or palladium, allowing efficient electrochemistry to take place. The material of the working electrode may be different from the material of the counter/reference electrode. For example, the material of the working electrode should have an electrochemical activity that does not exceed the electrochemical activity of the material of the counter/reference electrode. For example, the working electrode could be made of carbon and a silver or silver chloride reference/counter electrode may be used.
The two electrodes 38 and 40 may be of the same size or of different size. It may be of benefit to regulate by design the degree to which diffusion is defined by radial and planar diffusion. This could be achieved by designing electrodes with high surface to edge ratio to favor planar diffusion or high edge to surface ratio to favor radial diffusion. Another option would be to recess the electrode or border it with walls to limit or prevent radial diffusion. Working and counter/reference electrodes may be coated with the same reagents. These reagents should contain an electrochemically active species capable of undergoing reversible oxidation and reduction. Example species include but are not limited to potassium hexacyanoferrate III, potassium hexacyanoferrate II, ferrocene and ferrocene derivatives, osmium based mediators, gentisic acid and their functionalized derivatives. The reagent layer may also contain ionic salts to support the electrochemistry within the chamber.
The test strip may comprise multiple measuring electrodes allowing different voltage modulation patterns to be applied simultaneously or allowing several diagnostic tests to be carried out simultaneously. For example, the strip may include one or more working electrodes, a counter electrode and a reference electrode. The counter and reference may be the same electrode. The electrodes may optionally be enclosed within a sample chamber, such chamber having at least one aperture suitable for aspirating a sample of blood or other fluid of interest. The fill of the sample chamber may be aided by capillary, wicking, negative driven, electro-wetting or electro-osmotic forces. The reagents disposed on or around the electrodes may contain certain non-active film forming agents in addition to agents that promote the rapid dissolution of the electrochemically active species of interest in to the test sample.
The reagent layer(s) may over coat(s) one or more of the electrodes. In this case, substantially complete dissolution of the layer is required prior to interrogation of the bulk sample solution. Otherwise the layer itself would play a role in defining diffusion-related coefficients. The reagent layer may also be partially soluble over the measurement time. In this case, the rate of dissolution might provide a control measure.
Turning next to
The electronic meter 50 determines that the sample is in position via detection of a physical parameter (such as a resistance, capacitance, current, etc. . . . ) reaching a threshold value upon insertion of the strip. The meter 50 may have a voltage control unit 54 that is capable of applying and modulating the potential difference between two electrodes such that the species of interest can be repeatedly oxidized and reduced at the same electrode surface. The pulsed potential waveform may be defined as described below and predetermined by the meter. When the test strip 30 is equipped with multiple electrodes pairs 38 and 40, the control unit 54 can be configured to control each pair separately. In this case each pair 38, 40 may be modulated with a different pulse rate and/or different voltage amplitude. The means for measuring the current is configured to sample current at a frequency equal or greater than 0.2 Hz. The current can be measured at a defined time point or at a peak value. The processor can determine the current rate of change. The meter is configured to perform the methods described below. This can be done under the control of software and/or hardware.
Different types of potentials can be applied to the electrode 300 in order to drive an oxidation or a reduction reaction. The potential at which the redox reaction becomes limited by mass transport is the peak potential. When the potential applied to the electrode 300 is greater than the absolute peak oxidation or reduction potential, the potential is described as an over-potential. An over-potential is a potential of greater than or equal amplitude than that at which the redox reaction at an electrode 300 becomes limited by mass transport. At the over-potential, the theoretical concentration of the analyte being measured is substantially zero at the electrode surface 302 and current diffusion limited. An under-potential is a potential of lesser amplitude than that at which the redox reaction at the electrode 300 becomes limited by mass transport. The under-potential applied to the electrode 300 is less than the absolute peak oxidation or reduction potential (a potential at which current is not solely diffusion limited).
where:
i is the current in amperes;
n is the number of electrons to reduce or oxidize one molecule of analyte;
F is the Faraday constant;
cj0 is the initial concentration of the reducible analyte in mol/cm3;
Dj is the diffusion coefficient for the species in cm2/s; and
t is the time in seconds.
In qualitative terms, during the reduction 501 upon application of an under-potential, the current response is as depicted in graph 511, which shows a peak negative current followed by a current decay. In addition, during the oxidation 502 upon application of an over-voltage, the current response is as depicted in graph 512, which shows a peak positive current followed by a current decay. These current curves are predicted by the Cottrell equation, as noted above.
By way of explanation and when measuring an analyte concentration, the same voltage pulse will be applied, and different current responses will be measured during each such measurement. The current response shown in
Continuing with the example waveform of
An equation for calculating an intermediate analyte concentration G is set forth as follows:
In other examples, a more general polynomial equation in the variables xi may be used to calculate G, for example including terms such as bi,j,n,mxinxjm, where n and m range from zero to 3 (i.e., for a general cubic equation), and bi,j,n,m is a coefficient.
For the examples of
The constant and coefficients for this calculation are set forth in Table 3, in which each row represents a term which is to be multiplied by a coefficient (or an intercept term which is a constant), and the rows are added to calculate G1.
x1 · x10
x1 · x11
x1 · x12
x1 · x13
x1 · x14
x2 · x10
x2 · x11
x2 · x12
x2 · x13
x2 · x14
x3 · x10
x3 · x11
x3 · x12
x3 · x13
x3 · x14
x4 · x10
x4 · x11
x4 · x12
x4 · x13
x4 · x14
x5 · x10
x5 · x11
x5 · x12
x5 · x13
x5 · x14
x6 · x10
x6 · x11
x6 · x12
x6 · x13
x6 · x14
x7 · x10
x7 · x11
x7 · x12
x7 · x13
x7 · x14
x8 · x10
x8 · x11
x8 · x12
x8 · x13
x8 · x14
x9 · x10
x9 · x11
x9 · x12
x9 · x13
x9 · x14
x102
x112
x122
x132
x142
The constant and coefficients may be chosen so that G1 provides a general analyte concentration that has a wide range of applicability across analyte concentration levels.
The constant and coefficients for this calculation are set forth in Table 4, in which each row represents a term which is to be multiplied by a coefficient (or an intercept term which is a constant), and the rows are added to calculate G2.
x1 · x10
x1 · x11
x1 · x12
x2 · x10
x2 · x11
x2 · x12
x3 · x10
x3 · x11
x3 · x12
x4 · x10
x4 · x11
x4 · x12
x5 · x10
x5 · x11
x5 · x12
x6 · x10
x6 · x11
x6 · x12
x7 · x10
x7 · x11
x7 · x12
x8 · x10
x8 · x11
x8 · x12
x9 · x10
x9 · x11
x9 · x12
x102
x112
x122
The constant and coefficients may be chosen so that G2 provides an analyte concentration that is more accurate at low glucose levels.
The constant and coefficients for this calculation are set forth in Table 5, in which each row represents a term which is to be multiplied by a coefficient (or an intercept term which is a constant), and the rows are added to calculate G3.
x102
x112
x122
x132
x142
x152
In one example, a simple polynomial equation in the single measured current value may be used to calculate a fourth intermediate analyte concentration G4, as set forth below:
G
4
=a+bx+cx
2
+dx
3, where a=−16, b=63, c=1.8, and d=0.003.
In one embodiment, the method 900 at block 910 applies at least three (3) voltage pulses across the two electrodes, which may include the electrodes 38, 40 as described with respect to
With further reference to
The specific details of the calculations of four (4) intermediate analyte concentrations are set forth with respect to
Turning next to
If the temperature of the fluid is within the predetermined range, the method 900 at blocks 954, 956, 958 may be programmed to select a different calculation, depending on the outcome of the G1 calculation. For example, the method 900 at block 954 may select G2, as set forth with respect to
Continuing with
Initially, the method 900 at block 962 determines if the analyte concentration level is below a predetermined threshold, using, for example, the first intermediate analyte concentration G1 to make the determination. If the analyte concentration level is not below the predetermined threshold, then the method 900 at block 964 checks if the absolute bias between G1 and G4 is below a predetermined threshold. For example, the predetermined threshold for absolute bias may be 25 mg/dL, 35 mg/dL, or another value between 10-50 mg/dL. If the analyte concentration is below the predetermined threshold, then the method 900 at block 966 checks if the relative bias between G1 and G4 is below a predetermined threshold. For example, the predetermined threshold for relative bias may be 40%, 35%, or another value between 10-50%. In either case, if the bias is not below the predetermined threshold, the method 900 at block 968 reports an error. Alternatively, if the bias is below the predetermined threshold, the method 900 at block 970 can report or annunciate the results of the calculation performed at block 950.
While the invention has been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the invention is not limited to the variations or figures described. In addition, where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art will recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. Therefore, to the extent there are variations of the invention, which are within the spirit of the disclosure or equivalent to the inventions found in the claims, it is the intent that this patent will cover those variations as well.
To the extent that the claims recite the phrase “at least one of” in reference to a plurality of elements, this is intended to mean at least one or more of the listed elements, and is not limited to at least one of each element. For example, “at least one of an element A, element B, and element C,” is intended to indicate element A alone, or element B alone, or element C alone, or any combination thereof. “At least one of element A, element B, and element C” is not intended to be limited to at least one of an element A, at least one of an element B, and at least one of an element C.
This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”), and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a method or device that “comprises,” “has,” “includes,” or “contains” one or more steps or elements possesses those one or more steps or elements, but is not limited to possessing only those one or more steps or elements. Likewise, a step of a method or an element of a device that “comprises,” “has,” “includes,” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.
The corresponding structures, materials, acts, and equivalents of all means or step plus function elements in the claims below, if any, are intended to include any structure, material, or act for performing the function in combination with other claimed elements as specifically claimed. The description set forth herein has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art without departing from the scope and spirit of the disclosure. The embodiment was chosen and described in order to best explain the principles of one or more aspects set forth herein and the practical application, and to enable others of ordinary skill in the art to understand one or more aspects as described herein for various embodiments with various modifications as are suited to the particular use contemplated.