In recognition of the need for a standardization of the measurement of the erythrocyte sedimentation rate (ESR), the International Council for Standardization in Haematology (ICSH) makes the following recommendations:

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(i) The reference method for measurement of the ESR should be based on the Westergren method, which is a specific test for the ESR, with modifications,

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(ii) The reference method for measurement of the ESR should use either whole blood anticoagulated with EDTA and later diluted with sodium citrate or saline (4 : 1) or whole blood anticoagulated with sodium citrate (4 : 1) in Westergren pipettes,

 

(iii) The ESR pipettes can be of glass or plastic (with specific characteristics). It must be colourless; a minimum sedimentation scale of 200 mm, a minimum bore of 2.55 mm, which should be constant within 5%.

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A protocol for the evaluation of alternative methodologies against the reference method is outlined:

 

The new technologies must be tested over a range of ESR values of 2–120 mm. In this comparison, 95% of the differences should be 5 mm or less, with larger differences associated with higher ESR values.

 

A minimum of 40 samples should be tested in 3 different groups of values: 1–20, 21–60 and more than 60 mm.

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The statistical methods recommended for ESR evaluations are the coefficient of correlation, the Passing-Bablock regression and the Bland-Altman statistical method.

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This reference method replaces all earlier standardized and reference methods.