Collection and laboratory methods for dried blood spots for hemoglobin A1c and total and high-density lipoprotein cholesterol in population-based surveys

Clin Chim Acta. 2015 May 20;445:143-54. doi: 10.1016/j.cca.2015.03.028. Epub 2015 Mar 27.


Background: The Health Measures at Home Study was a study designed to evaluate the feasibility of incorporating dried blood spots (DBS) collection into the National Health Interview Survey and to compare the proficiencies between field interviewers and health technicians in obtaining DBS.

Methods: DBS collection and venipuncture were attempted on 125 participants. The DBS were collected in the participant's home and venous blood was collected in the National Health and Nutrition Examination Survey (NHANES) mobile examination center. The DBS results were compared to venous results in the NHANES for the measurements of hemoglobin A1c (HbA1c) and total and high-density lipoprotein (HDL) cholesterol.

Results: Field interviewers and health technicians were able to collect the DBS for greater than 95% of participants. For DBS, health technicians and field interviewers were highly correlated for HbA1c (r=0.92) and total cholesterol (r=0.89), but not for HDL cholesterol (r=0.72). The DBS results of interviewers and health technicians compared to the venous method for HbA1c (r=0.90), but did not compare well for HDL cholesterol (r=0.64-0.66) and total cholesterol (r=0.65-0.67).

Conclusion: DBS was comparable to venous HbA1c, but not for total and HDL cholesterol. Health technicians and field interviewers had similar performance for DBS methods, except HDL cholesterol.

Keywords: Diabetes; Dried blood spots; Laboratory method comparison; Lipids; Survey methods.

MeSH terms

  • Blood Specimen Collection / methods*
  • Dried Blood Spot Testing / statistics & numerical data
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Lipoproteins, HDL / blood*
  • Nutrition Surveys / methods*
  • Observer Variation
  • Phlebotomy / statistics & numerical data
  • Quality Control
  • Reproducibility of Results


  • Glycated Hemoglobin A
  • Lipoproteins, HDL
  • hemoglobin A1c protein, human