Young pediatric patients who undergo venipuncture or capillary blood sampling often experience high levels of pain and anxiety. This often results in distressed young patients and their parents, increased treatment times, and a higher workload for healthcare professionals. Social robots are a new and promising tool to mitigate children’s pain and anxiety. This study aims to purposefully design and test a social robot for mitigating stress and anxiety during blood draw of children. We first programmed a social robot based on the requirements expressed by experienced healthcare professionals during focus group sessions. Next, we designed a randomized controlled experiment in which the social robot was applied as a distraction method to measure its capacity to mitigate pain and anxiety in children during blood draw in a children’s hospital setting. Children who interacted with the robot showed significantly lower levels of anxiety before actual blood collection, compared to children who received regular medical treatment. Children in the middle classes of primary school (aged 6–9) seemed especially sensitive to the robot’s ability to mitigate pain and anxiety before blood draw. Children’s parents overall expressed strong positive attitudes toward the use and effectiveness of the social robot for mitigating pain and anxiety. The results of this study demonstrate that social robots can be considered a new and effective tool for lowering children’s anxiety prior to the distressing medical procedure of blood collection.

Objectives: This study examined the comparability of venous and capillary blood samples with regard to routine chemistry analytes. Methods: Venous and capillary blood samples were collected from adult patients to assess comparability of alanine transaminase, albumin, alkaline phosphatase, apolipoprotein B, aspartate aminotransferase, total bilirubin, calcium, chloride, creatin kinase, creatinine, C-reactive protein, ferritin, folic acid, free T4, gamma glutamyltransferase, glucose, high density lipoprotein cholesterol, iron, lipase, lipoprotein a, magnesium, phosphate, postassium, prostate specific antigen, sodium, total cholesterol, total protein, transferrin, triglycerides, thyroid stimulating hormone, urate, urea, vitamin B12 and 25-hydroxyvitamin-D3. Furthermore, hemolysis-icterus-lipemia Index (HIL-Index) was measured for all samples. All measurements were performed using the Siemens Atellica ^® CH or IH Analyzer. Deming regression analysis and mean relative differences between venous and capillary measurements of each analyte were contrasted with the desirable total allowable error (TEa) and Clinical Laboratory Improvement Amendments (CLIA) 2024 proposed acceptance limits for proficiency testing. Results: Deming regression and mean relative differences demonstrated excellent comparability between venous and capillary samples for most measured analytes. Conclusions: Capillary and venous samples showed comparable results for almost all studied chemistry analytes. Of the 33 studied analytes for which TEa criteria where available, 30 met TEa criteria. CLIA 2024 criteria where available for 29 of the studied analytes of which only glucose did not meet the criteria. In conclusion, capillary blood draw is a suitable alternative for venous blood sampling for measuring most of the investigated analytes. This benefits patients with fear of needles and might pave the way for remote self-sampling.

C-reactive protein (CRP) is an acute-phase protein involved in inflammation. Furthermore, CRP is an important biomarker used in diagnostics to predict risk of cardiovascular disease (CVD) in addition to monitoring bacterial and viral infections. To measure plasma CRP, venipuncture is still necessitated and has to be performed by trained phlebotomists. As a solution, dried blood spots (DBS) are used for minimally invasive at-home sampling of blood and can be send to diagnostic laboratories by regular mail. In this study, we included 53 patients that presented to the outpatient clinic of the University Medical Center Utrecht. Capillary finger stick was used to spot blood on a filter paper card and allowed to dry. After extraction of DBS, CRP was analyzed on an automated high-throughput chemistry analyzer. Additional validation steps regarding stability, effect of hematocrit, precision, and limits of blank and quantitation were conducted according to corresponding Clinical and Laboratory Standards Institute standards. An excellent regression analysis of R² (95% confidence interval) = 0.986 (0.982–0.989) was found. This enabled correct classification for high CVD risk of all 25 cases with sensitivity (95% CI) of 1.00 (1.00–1.00) and specificity (95% CI) of 0.96 (0.89–1.03) and correct diagnosis of inflammation of 12/13 cases with sensitivity (95% CI) of 0.92 (0.77–1.07) and specificity (95% CI) of 1.00 (1.00–1.00). Furthermore, CRP was found to be stable for 31 days and observed hematocrit variation amongst patients was clinically acceptable. CRP from DBS can be accurately measured on an automated high-throughput chemistry analyzer and used to diagnose inflammation and classify high CVD risk. This method enables individuals to engage in at-home sampling of blood on DBS for (tele)diagnostics, screening programs, patient follow-up, and medication management.

Healthcare practitioners often use distraction techniques to ease children’s anxiety during blood draws. This study explored the effectiveness of a social robot, Softbank Robotics NAO, in reducing anxiety and pain for children aged 4-12 during blood draws. The robot engaged with children using behaviors tailored to the children’s age. Interestingly, results indicated the robot significantly increased anxiety, but pain levels remained unchanged. We argue that this effect may result from the robot’s novelty and that, over the long term, the robot could have a positive impact on anxiety, consistent with other studies. This research underscores the potential of social robots to alleviate children’s anxiety in medical procedures, enhancing patient experience in pediatric healthcare.

Patients with primary antibody deficiencies receiving immunoglobulin replacement therapy require frequent monitoring of immunoglobulin G (IgG) levels. Capillary IgG measurements from dried blood spots (DBS) or microtubes offer several advantages over samples obtained by venipuncture, including facilitating remote self-sampling. However, the validity of this alternative method is still unknown. We evaluated the comparability of IgG levels measured in venous samples with capillary blood samples collected on DBS cards and in microtubes. Paired venous and capillary finger-stick DBS and microtube samples were collected from 100 patients. IgG was extracted from DBS with phosphate buffered saline and measured with a Siemens Atellica CH. For method comparison we performed Deming regression analysis. Absolute mean bias and limits of agreement were calculated with Bland-Altman analysis. The method comparison followed the Clinical Laboratory Improvement Amendments' (CLIA) recommended approach, but stricter limits proposed by the EFLM were applied. Relative mean differences were compared to a 10.9 % total allowable error (TEa). Method comparison of venous versus capillary DBS samples resulted in an R of 0.77. Mean bias was 0.23 g/L with limits of agreement of -4.06 g/L to 4.53 g/L. Method comparison of venous versus capillary microtube samples resulted in an R of 1.00. Mean bias was -0.11 g/L with -0.67 g/L to 0.46 g/L limits of agreement. Relative mean differences were 2.2 % for DBS sampling and -0.6 % for capillary sampling, both fall within 10.9 % TEa and CLIA criteria. IgG measurements from DBS demonstrated insufficient correlation and excessively broad limits of agreement, making it unsuitable for accurately determining IgG levels. This result hampers implementation of DBS in routine diagnostics. Conversely, capillary microtube samples demonstrated a strong correlation and narrow limits of agreement, which makes them a viable alternative to venipuncture.

A 34-year-old woman presented to the emergency department with abdominal pain and vaginal bleeding following a positive urine pregnancy test. The patient was referred to the gynecologist. Remarkably, her serum was cola-colored ( Fig. 1). Ultrasonography showed an ectopic pregnancy (EP) in the right fallopian tube and fluid collection intraperitoneally. Salpingectomy revealed a ruptured fallopian tube and hemorrhage embedding the EP.