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Objectives As one of the most widely used tests, the erythrocyte sedimentation rate (ESR) is a measurement of sedimentation reaction in blood samples. Although the recommended method for ESR measurement is the Westergren method, this method has some disadvantages in comparison with automated ESR systems. In this cross-sectional study, we aimed to compare Vision c with the Westergren method. Methods The Vision c automated ESR system and the modified Westergren method were compared using K 3 EDTA-containing tubes and citrated blood tubes from randomly selected 100 patients. Precision, bias, and interference calculations were performed. Results The mean difference between the Vision c (room temperature) and the modified Westergren method was 22.8 ± 26.6 mm/h (95% CI for the mean was 17.50–28.08 mm/h). The mean difference between the Vision c (18 °C) and the modified Westergren method was 27.4 ± 30.6 mm/h (95% CI for the mean was 21.3–33.5 mm/h). The calculated regression analysis equation was “ y =  0.263  +  1.053x ” and “ y = − 0.530  +  0.851x ” for the Vision c (room temperature) and the Vision c (18 °C), respectively. The imprecision values ranged at 7.55–17.09%. According to our external quality control results, bias was 11.11 and 9.66 for the low- and high-level samples, respectively. Conclusions The Vision c automated ESR system has a comparable analytical performance with the modified Westergren method. The Vision c automated system may be utilized in ESR measurements with quality control evaluations. Nevertheless, temperature correction using Manley’s monogram causes an important negative bias and should be taken into consideration during the evaluation of the Vision c results.

Is Vision C interchangeable with the modified Westergren method for the erythrocyte sedimentation rate?