Expert comments

Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

Three experts were aware of the technology, none had used it in their clinical practice.

Level of innovation

All expert commentators agreed that the technology is novel. One commentator noted Helge is innovative in its concept and in current practice, large clinical chemistry analysers generally incorporate spectrophotometric haemolysis checks. Another expert suggested that there is a high haemolysis rate in blood samples taken in emergency departments. Knowing about haemolysis early would mean that samples can be taken and repeated quickly, reducing delays and improving patient flow. None of the experts were aware of any similar technology to do these tests at point of care.

Potential patient impact

One expert thought that the technology would allow the detection of unsuspected haemolysis in blood gas or electrolyte samples. This could avoid incorrect potassium readings that can result in patient harm through inappropriate treatment. The expert indicated that the rate of moderate to severe haemolysis in blood gas samples is about 6% and most blood gas analysers do not incorporate haemolysis checks. Therefore, the technology would be of particular value to patients having blood gas analysis when haemolysis checks are generally not currently available. Another expert considered the potential benefits of Helge in the emergency department. This could include, for instance, avoiding false conclusions about hyperkalaemia by checking for haemolysis in blood gas (or other point-of-care) samples.

For blood tube samples, 2 experts thought that Helge would allow earlier identification of haemolysis and an earlier opportunity to take a fresh blood sample. This would improve the turnaround time of test results and reduce the number of tests being run without a valid result in the laboratory. One expert thought this could speed up clinical decision making in the emergency department, reducing patient waits and improving flow of patients. This expert considered that people with hyperkalaemia and people with suspected acute coronary syndromes having troponin testing (when the troponin assay is affected by haemolysis) would be most likely to benefit from this technology.

One expert indicated that there were very few benefits to patients in using the technology and stated that Helge may cause unnecessary rejection of samples.

Potential system impact

Reduced delays to final blood results by recognising haemolysed blood in blood tube samples is a key benefit to the healthcare system. For blood tube samples, 1 expert thought that there would be a saving in reagent costs. This would happen if any samples in which haemolysis was detected at point of care were not sent to the laboratory.

General comments

All commentators thought Helge would be an additional intervention to current standard care for detecting haemolysis in blood samples. The experts noted that the technology is not yet used in the NHS, and there is very limited evidence on the clinical and cost effectiveness. The barriers to using the test in the NHS could be the cost of the technology and potential issues with patients agreeing to use Helge.