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Zhang C, Yan Y, Zhang C. Evaluation of imprecision in the different detection methods of Zn based on 5 years of data from an external quality assessment program in China. J Trace Elem Med Biol 2024; 84:127451. [PMID: 38636293 DOI: 10.1016/j.jtemb.2024.127451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND This study examines the imprecision of zinc (Zn) measurements across various clinical detection methods by analyzing the external quality assessment (EQA) data from 2018 to 2022. The findings of this study aim to offer recommendations for enhancing Zn measurements. METHODS Participating laboratories were grouped into peer categories based on the detection methods. The robust mean and coefficient of variation (CV) of the samples were calculated following ISO 13528 guidelines. The evaluation criteria for optimal, desirable, and minimum allowable imprecision in Zn estimation are 2.50%, 5.05%, and 7.55%, respectively, based on biological variation. Furthermore, the study examined inter-lab CVs, inter-method bias, and the passing rate. The impact of sample concentration on CVs and the pass rate was also investigated. RESULTS Over the past five years, 4283 laboratories participated in the EQA program, showing a high pass rate that improved as sample concentration increased. Differential pulse polarography (DPP) demonstrated stable and low CVs (0.61-1.86%). Although differential pulse stripping (DPS) was less stable than DPP, it still exhibited a low CV (0.71-3.10%). Graphite furnace atomic absorption spectrometry (GFAAS) and flame atomic absorption spectrometry (FAAS) performed similarly and displayed stable CVs (2.39-4.42%) within the acceptable range of desirable imprecision (5.05%). However, the CVs for ICP-MS were unacceptable in three out of the five years (5.28-6.20%). In 2022, the number of participating laboratories for DDP, DPS, GFAAS, FAAS and ICP-MS is 131, 35, 35, 820 and 72, respectively. CONCLUSION This study provides reliable insights into the imprecision of Zn measurements in clinical laboratories. The findings indicate that additional efforts are required to reduce the imprecision of ICP-MS in Zn measurements.
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Affiliation(s)
- Chao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China; Peking Union Medical College, Beijing, PR China.
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China.
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Sandberg S, Zima T, Panteghini M. Analytical performance specifications - moving from models to practical recommendations. Clin Chem Lab Med 2024; 0:cclm-2024-0661. [PMID: 38841878 DOI: 10.1515/cclm-2024-0661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Affiliation(s)
- Sverre Sandberg
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tomas Zima
- Institute of Medical Chemistry and Laboratory Medicine, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Mauro Panteghini
- Department of Laboratory Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
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Panteghini M. What the Milan conference has taught us about analytical performance specification model definition and measurand allocation. Clin Chem Lab Med 2024; 0:cclm-2023-1257. [PMID: 38277658 DOI: 10.1515/cclm-2023-1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
Analytical performance specifications (APS) represent the criteria that specify the quality required for laboratory test information to satisfy clinical needs. In 2014 the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) considered timely to update the topic of APS by organizing a conference in Milan in which some strategic concepts were proposed. Here I summarize the essential points representing the EFLM Strategic Conference heritage and discuss the approaches that will permit us to become more concrete, including roles and main actions expected from each of involved stakeholders for contributing a quantum leap forward in the way of practicality of Milan consensus about APS.
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Affiliation(s)
- Mauro Panteghini
- Department of Laboratory Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Torun, Poland
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Kolho KL, Lahtiharju T, Merras-Salmio L, Pakarinen MP, Knip M. Infant liver biochemistry is different than current laboratory accepted norms. Eur J Pediatr 2023; 182:5707-5711. [PMID: 37812243 PMCID: PMC10746582 DOI: 10.1007/s00431-023-05248-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 08/30/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
The purpose is to study liver biochemistry in a well-defined cohort of term infants. The methods include healthy term infants (n = 619) provided blood samples at 3 and 6 months of age when participating to the DIABIMMUNE study. The infants were followed up at clinical study visits 3, 6, 12, 18, 24, and 36 months the participation rate being 88.6% at the end of follow-up, while none disclosed any signs of a liver disease. The serum levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin (BIL), and conjugated bilirubin (BIL-conj) were determined using Siemens Atellica CH 930 analyzers. The results are at 3 months of age, the upper 90% CI for ALT, AST, ALP, GGT, BIL, and BIL-conj were higher than the current upper reference limits in our accredited hospital laboratory. At 6 months, the upper 90% CIs for ALT had declined but was still higher than the cut-offs for a raised value. The upper 90% CI for AST remained as high as at 3 months, whereas ALP, BIL-conj, and GGT had decreased close to the current cut-offs. The type of feeding was associated with the levels of liver biochemistry. Exclusively or partially breastfed infants showed higher ALT, AST, BIL, and BIL-conj values at 3 months than formula-fed. Breastfed infants had higher AST, Bil, and Bil-conj values also at 6 months. Conclusion: We encourage setting appropriate reference ranges for liver biochemistry for the first year of life and to note the type of feeding. What is Known: • Healthy infants may show higher values of liver biochemistry during their first year of life than in later life. • It has been speculated that type of feeding may play a role in liver biochemistry levels among infants. What is New: • In a cohort of healthy infants, several analytes of liver biochemistry were higher than the currently used upper reference limits at 3 and 6 months of age, and exclusively or partially breastfed infants showed higher values than formula-fed. • The findings address the importance of setting appropriate reference ranges for liver biochemistry for the first year of life.
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Affiliation(s)
- Kaija-Leena Kolho
- Department of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, P.O. Box 281, FI-00029, Helsinki, Finland.
| | - Tapio Lahtiharju
- Department of Clinical Laboratory, HUSLAB, Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Laura Merras-Salmio
- Department of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, P.O. Box 281, FI-00029, Helsinki, Finland
| | - Mikko P Pakarinen
- Department of Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Mikael Knip
- Department of Pediatric Gastroenterology, Children's Hospital, University of Helsinki, P.O. Box 281, FI-00029, Helsinki, Finland
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Ghali S, Etienne C, Bérénice O, Romy G. Test results comparison: is the S-Monovette ® Lithium-Heparin Gel+ a suitable replacement for the S-Monovette ® Lithium-Heparin Gel on Alinity Abbott ®? Clin Chem Lab Med 2023; 61:e148-e151. [PMID: 36848494 DOI: 10.1515/cclm-2022-1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/24/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Sqalli Ghali
- Department of Clinical Chemistry, University Hospital of Liege, Liège, Belgium
| | - Cavalier Etienne
- Department of Clinical Chemistry, University Hospital of Liege, Liège, Belgium
| | - Onkelinx Bérénice
- Department of Clinical Chemistry, University Hospital of Liege, Liège, Belgium
| | - Gadisseur Romy
- Department of Clinical Chemistry, University Hospital of Liege, Liège, Belgium
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Sandberg S, Carobene A, Bartlett B, Coskun A, Fernandez-Calle P, Jonker N, Díaz-Garzón J, Aarsand AK. Biological variation: recent development and future challenges. Clin Chem Lab Med 2022; 61:741-750. [PMID: 36537071 DOI: 10.1515/cclm-2022-1255] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 02/18/2023]
Abstract
Abstract
Biological variation (BV) data have many applications in laboratory medicine. However, these depend on the availability of relevant and robust BV data fit for purpose. BV data can be obtained through different study designs, both by experimental studies and studies utilizing previously analysed routine results derived from laboratory databases. The different BV applications include using BV data for setting analytical performance specifications, to calculate reference change values, to define the index of individuality and to establish personalized reference intervals. In this review, major achievements in the area of BV from last decade will be presented and discussed. These range from new models and approaches to derive BV data, the delivery of high-quality BV data by the highly powered European Biological Variation Study (EuBIVAS), the Biological Variation Data Critical Appraisal Checklist (BIVAC) and other standards for deriving and reporting BV data, the EFLM Biological Variation Database and new applications of BV data including personalized reference intervals and measurement uncertainty.
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Affiliation(s)
- Sverre Sandberg
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Norwegian Porphyria Centre, Haukeland University Hospital , Bergen , Norway
- Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Bill Bartlett
- School of Science and Engineering, University of Dundee , Dundee , Scotland
| | - Abdurrahman Coskun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine , Istanbul , Türkiye
| | - Pilar Fernandez-Calle
- Hospital Universitario La Paz, Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC) , Madrid , Spain
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen , Assen , The Netherlands
| | - Jorge Díaz-Garzón
- Hospital Universitario La Paz, Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC) , Madrid , Spain
| | - Aasne K. Aarsand
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Norwegian Porphyria Centre, Haukeland University Hospital , Bergen , Norway
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Plebani M, Gillery P, Greaves RF, Lackner KJ, Lippi G, Melichar B, Payne DA, Schlattmann P. Rethinking internal quality control: the time is now. Clin Chem Lab Med 2022; 60:1316-1317. [PMID: 35766232 DOI: 10.1515/cclm-2022-0587] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Mario Plebani
- Medical School, University of Padova-Italy, Padova, Italy
| | - Philippe Gillery
- Laboratory of Biochemistry-Pharmacology-Toxicology, University Hospital of Reims, Reims, France
| | - Ronda F Greaves
- Biochemical Genetics, Victorian Clinical Genetics Services Ltd, Parkville, VIC, Australia
| | - Karl J Lackner
- Medical Center of the Johannes Gutenberg-University, Institute of Clinical Chemistry and Laboratory Medicine, Mainz, Germany
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | | | | | - Peter Schlattmann
- Computer and Data Sciences, University Hospital Jena, Institute of Medical Statistics, Jena, Germany
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Plebani M. Quality in laboratory medicine and the Journal: walking together. Clin Chem Lab Med 2022; 61:713-720. [PMID: 35969689 DOI: 10.1515/cclm-2022-0755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/15/2022]
Abstract
Quality in laboratory medicine is defined as "an unfinished journey", as the more essential the laboratory information provided, the more assured its quality should be. In the past decades, the Journal Clinical Chemistry and Laboratory Medicine has provided a valuable forum for garnering new insights into the analytical and extra-analytical phases of the testing cycle, and for debating crucial aspects of quality in clinical laboratories. The impressive number of papers published in the Journal is testimony to the efforts made by laboratory professionals, national and international scientific societies and federations in the quest to continuously improve upon the pre-, intra- and post-analytical steps of the testing cycle, thus enhancing the quality of laboratory information. The paper appearing in this special issue summarizes the most important and interesting contributions published in the Journal, thus updating our knowledge on quality in laboratory medicine and offering further stimuli to identify the most valuable measures of quality in clinical laboratories.
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Affiliation(s)
- Mario Plebani
- Clinical Biochemistry and Clinical Molecular Biology, University of Padova, Padova, Italy
- Department of Pathology, University of Texas Medical Branch, Galveston, USA
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