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We appreciate the valuable input from Puzone and colleagues regarding our paper, “Agreement between intermittent glucose concentrations and continuous glucose monitoring (CGM) in at-risk newborns.” Our research aimed to evaluate the feasibility and accuracy of non-invasive screening for neonatal hypoglycemia in at-risk newborns.

我们感谢Puzone及其同事对我们的论文“高危新生儿间歇性血糖浓度与连续血糖监测（CGM）之间的一致性”的宝贵意见。我们的研究旨在评估无创筛查高危新生儿低血糖的可行性和准确性。

The Dexcom G6 continuous glucose monitor, a factory-calibrated device, was employed as the non-invasive instrument in this investigation. It was compared with the i-STAT glucometer, a bedside laboratory-quality glucose concentration analyzer and the standard-of-care to intermittently determine glucose levels in our Newborn Nursery and NICU, which necessitated frequent needle sticks.

Dexcom G6连续血糖监测仪是一种工厂校准的设备，在本研究中被用作非侵入性仪器。它与i-STAT血糖仪，床边实验室质量葡萄糖浓度分析仪和护理标准进行了比较，以间歇性地确定我们新生儿托儿所和NICU中的葡萄糖水平，这需要频繁的针刺。

Because the i-STAT analyzers are superior to point-of-care (POC) glucometers in precision, we compared glucose concentrations from the Dexcom G6 to the i-STAT, rather than less accurate POC glucometers.Our results revealed a substantial and proportional discrepancy when compared to the laboratory-quality i-STAT glucose levels.

由于i-STAT分析仪的精度优于即时血糖仪（POC），因此我们比较了Dexcom G6和i-STAT的葡萄糖浓度，而不是不太准确的POC血糖仪。与实验室质量的i-STAT葡萄糖水平相比，我们的结果显示出显着且成比例的差异。

From an analytic standpoint, we agree with Puzone et al that Mean Absolute Relative Difference (MARD) is not an optimal measure to characterize the performance of the Dexcom G6 compared to the i-STAT. In our paper, we presented the Bland-Altman analysis as the primary result, which is a more suitable statistical method to ascertain the potential adoption of the new screening approach in lieu of the current standard.

从分析的角度来看，我们同意Puzone等人的观点，即与i-STAT相比，平均绝对相对差异（MARD）不是表征Dexcom G6性能的最佳指标。在本文中，我们提出了Bland-Altman分析作为主要结果，这是一种更合适的统计方法，可以确定是否可能采用新的筛选方法代替当前标准。

Consequently, utilizing Bland-Altman analysis rather than MARD, we concluded that the Dexcom G6 was not accurate, particularly at the low glucose concentrations common in newborns, and was unsuitable as a trending device due to proportional bias. Moreover, we observed that retrospective sensor calibration in real-time did not mitiga.

因此，利用Bland-Altman分析而不是MARD，我们得出结论，Dexcom G6不准确，特别是在新生儿常见的低葡萄糖浓度下，由于比例偏差，不适合作为趋势设备。此外，我们观察到实时回顾性传感器校准并没有减轻。

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Fig. 1: Clarke error grid analyses.

。

AcknowledgementsThis work was supported by the Gerber Foundation and the Children’s Miracle Network.FundingThis study was primarily funded by the Gerber Foundation. Dexcom provided an investigator-initiated research grant to provide Dexcom sensors and supplies. Children’s Miracle Network provided a grant for start-up funds.Author informationAuthors and AffiliationsDepartment of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, PA, USAN.

致谢这项工作得到了格伯基金会和儿童奇迹网络的支持。资助这项研究主要由格伯基金会资助。Dexcom提供了由研究者发起的研究资助，以提供Dexcom传感器和用品。儿童奇迹网络为创业基金提供了赠款。。

S. PatelDepartment of Pediatrics, Division of Neonatology, Lehigh Valley Reilly Children’s Hospital, Allentown, PA, USAR. P. DukeDepartment of Public Health Sciences, Division of Biostatistics and Bioinformatics, Penn State College of Medicine, Hershey, PA, USAZ. Tian & S. ZhouDepartment of Pediatrics, Division of Neonatal-Perinatal Medicine, Penn State Health Children’s Hospital, Hershey, PA, USAJ.

S、 美国宾夕法尼亚州阿伦顿市Lehigh Valley Reilly儿童医院新生儿科儿科。P、 DukeDepartment of Public Health Sciences，Division of Biostatistics and Bioinformatics，宾夕法尼亚州立医学院，Hershey，PA，USAZ。田和S。周美国宾夕法尼亚州好时宾夕法尼亚州立健康儿童医院新生儿围产期医学科儿科。

R. KaiserAuthorsN. S. PatelView author publicationsYou can also search for this author in.

R、 KaiserAuthorsN。S、 PatelView作者出版物您也可以在中搜索此作者。

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PubMed Google ScholarContributionsNP conceptualized and designed the study, analyzed data, interpreted results, and drafted the manuscript. RD assisted in conceptualizing and designing the study. ZT and SZ analyzed data and provided statistical support. JK made contributions to analyzing the data, interpreting the results, and revising the manuscript.

PubMed谷歌学术贡献SNP对研究进行了概念化和设计，分析了数据，解释了结果，并起草了手稿。RD协助概念化和设计研究。ZT和SZ分析了数据并提供了统计支持。JK为分析数据，解释结果和修改手稿做出了贡献。

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.Corresponding authorCorrespondence to.

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Additional informationPublisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissionsReprints and permissionsAbout this articleCite this articlePatel, N.S., Duke, R.P., Tian, Z. et al. Statistical analysis of continuous glucose monitoring in at-risk newborns..

Additional informationPublisher的注释Springer Nature在已发布的地图和机构隶属关系中的管辖权主张方面保持中立。权利和许可打印和许可本文引用本文Patel，N.S.，Duke，R.P.，Tian，Z。等人。高危新生儿连续血糖监测的统计分析。。

J Perinatol (2024). https://doi.org/10.1038/s41372-024-02072-5Download citationReceived: 28 June 2024Revised: 12 July 2024Accepted: 17 July 2024Published: 24 July 2024DOI: https://doi.org/10.1038/s41372-024-02072-5Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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