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Miller JJ, Gammie AJ. A Novel Approach for Routinely Assessing Laboratory Sigma Metrics for a Broad Range of Automated Assays. J Appl Lab Med 2024; 9:477-492. [PMID: 38391346 DOI: 10.1093/jalm/jfad125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/24/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Sigma metrics have been adapted for the clinical laboratory to incorporate observed accuracy, precision, and total error allowed. The higher the Sigma level for a process, the better performance that process has. A limitation of studies assessing Sigma metrics is that they are performed on a small number of well-controlled systems. METHODS An algorithm was developed to extract QC data and derive the Sigma metric for 115 analytes from sites connected to the QuidelOrtho E-Connectivity® database. The median of these results was then used to derive the Sigma metric for each assay. RESULTS In this analysis, 79 out of 115 (68.7%) of the assays assessed achieved 6 Sigma or better and 98 out of 115 (85.2%) achieved 5 Sigma or better. CONCLUSIONS This study has demonstrated a methodology that can be used to condense Sigma metrics from hundreds of analyzers into a single metric of assay quality. Because these analyzers are running in working laboratories from around the world, this analysis can serve as a baseline for understanding the assay performance achieved in the presence of variabilities such as lab-to-lab, instrument-to-instrument, material handling, environmental conditions, and reagent lot. The significant number of assays demonstrating high Sigma levels did so despite this variation. The ability of the methods reported here to include hundreds of analyzers represents a novel approach for assessing Sigma metrics in clinical laboratories.
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Affiliation(s)
- Johanna J Miller
- Automation and Portfolio Solutions, QuidelOrtho Corporation, Rochester, NY, United States
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Sharma P, Singh M, Singh A, Bhardwaj D, Bhatia P. Experience of quantity and quality of DNA and RNA extraction from limited pediatric blood samples: A comparative analysis of automated and manual kit-based method. INDIAN J PATHOL MICR 2022; 65:105-110. [PMID: 35074973 DOI: 10.4103/ijpm.ijpm_946_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Optimal DNA and RNA quantity and purity is essential for downstream molecular biology experimentation and to avoid re-processing of sample. Despite availability of different kits and automated systems for nucleic acid isolation there is limited data on their performance evaluation, more so with pediatric blood samples, that are usually compromised in quantity. Hence, we evaluated the performance of automated QIAcube platform using pediatric blood samples in parallel with manual Qiagen extraction kits. MATERIALS AND METHODS : A total of 500 samples were analyzed based on groups of PBMC and direct blood input. The isolated DNA and RNA were surveyed for quantity and quality tests by spectrophotometric and downstream analysis. RESULTS : There was no significant difference in the DNA quantity (ng/ul) between manual and automated method based on similar sample input but quality (260/280) was significantly better with the QIAcube platform when direct blood and or PBMCs were used for extraction respectively (1.82 ± 004 Vs. 1.84.002; P-0.000008 and 1.859 ± 005 Vs. 1.843 ± 0.003; P-0.02). Moreover, the standard error mean was low for both quantity and quality in the QIAcube method suggesting uniformity. Comparison of quality assessment by spectrophotometer and qubit fluorimeter showed that QIAcube sheared DNA less (P- 0.038) as compared to manual method (P-0.013). Also, time taken to process the samples in QIAcube was 23% less than the kit-based method. CONCLUSION Overall analysis of QIAcube platform suggests that it yields more better, uniform, and less-sheared quality of nucleic acid in a relatively less time as compared to manual extraction kits.
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Affiliation(s)
- Pankaj Sharma
- Pediatric Hematology-Oncology Laboratory, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Minu Singh
- Pediatric Hematology-Oncology Laboratory, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditya Singh
- Pediatric Hematology-Oncology Laboratory, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepshikha Bhardwaj
- Pediatric Hematology-Oncology Laboratory, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prateek Bhatia
- Pediatric Hematology-Oncology Laboratory, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Multiple sequence alignment (MSA) is the basis for almost all sequence comparison and molecular phylogenetic inferences. Large-scale genomic analyses are typically associated with automated progressive MSA without subsequent manual adjustment, which itself is often error-prone because of the lack of a consistent and explicit criterion. Here, I outlined several commonly encountered alignment errors that cannot be avoided by progressive MSA for nucleotide, amino acid, and codon sequences. Methods that could be automated to fix such alignment errors were then presented. I emphasized the utility of position weight matrix as a new tool for MSA refinement and illustrated its usage by refining the MSA of nucleotide and amino acid sequences. The main advantages of the position weight matrix approach include (1) its use of information from all sequences, in contrast to other commonly used methods based on pairwise alignment scores and inconsistency measures, and (2) its speedy computation, making it suitable for a large number of long viral genomic sequences.
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Affiliation(s)
- Xuhua Xia
- Department of Biology, University of Ottawa, Marie-Curie Private, Ottawa, ON K1N 9A7, Canada; ; Tel.: +1-613-562-5718
- Ottawa Institute of Systems Biology, University of Ottawa, Ottawa, ON K1H 8M5, Canada
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Fu Q, Ye C, Han B, Zhan X, Chen K, Huang F, Miao L, Yang S, Wang W. Designing and Validating Autoverification Rules for Hematology Analysis in Sysmex XN-9000 Hematology System. Clin Lab 2021; 66. [PMID: 32255287 DOI: 10.7754/clin.lab.2019.190726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hematology analysis is a common test among patients in hospital. However, manual verification of hematology analysis is time consuming and tedious, with variation between inter-individual laboratory workers. This study was to establish and validate a set of autoverification rules for hematology analysis in the department of laboratory medicine, Zhongshan Hospital of Sun Yatsen University. METHODS Hematology analysis was measured by a Sysmex XN-9000 hematology system in the Department of Laboratory Medicine, Zhongshan Hospital of Sun Yatsen University. SYSMEX Laboman EasyAccess 6.0 and the laboratory information system were used to construct the algorithm and design the autoverification rules of hematology analysis according to Clinical and Laboratory Standards Institute document Auto 10A and 41 rules of Hematology Review Criteria. The laboratory turnaround time (TAT), autoverification pass rates, false positive, false negative, and the average error rate were verified after implementing autoverification rules. RESULTS Approximate 1,300 specimens were collected daily and transferred to our laboratory for hematology analysis; that is necessary to build a database and to design autoverification rules. The average autoverification passing rate was 81%; the false positive rate was 13.6%; the false negative rate and the average error rate was nearly zero, indicating that incorrect reports were almost eliminated. Moreover, since implementing autoverification, the TAT was reduced by 27.0% in in-patient reports, by 21.9% in out-patient reports, and by 39.0% in emergency reports, which enhanced the productivity in our laboratory. CONCLUSIONS Our laboratory accelerated verification and decreased TAT and the odds of human review errors in the released results since implementing the autoverification. Thus, we can save more time and concentrate on verifying the abnormal results and processing emergency tests.
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Nass SA, Hossain I, Sanyang C, Baldeh B, Pereira DIA. Hemoglobin point-of-care testing in rural Gambia: Comparing accuracy of HemoCue and Aptus with an automated hematology analyzer. PLoS One 2020; 15:e0239931. [PMID: 33002049 PMCID: PMC7529235 DOI: 10.1371/journal.pone.0239931] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/15/2020] [Indexed: 11/18/2022] Open
Abstract
Background Anemia is one of the most impactful nutrient deficiencies in the world and disproportionately affects children in low-resource settings. Point-of-care devices (PoCDs) measuring blood hemoglobin (Hb) are widely used in such settings to screen for anemia due to their low cost, speed, and convenience. Here we present the first iteration of Aptus, a new PoCD which measures Hb and hematocrit (HCT). Aim To evaluate the accuracy of Aptus and HemoCue® Hb 301 against an automated hematology analyzer (Medonic®) in Gambian children aged 6–35 months and the Aptus’ usage in the field. Methods Aptus, HemoCue® and Medonic® were compared using venous blood (n = 180), and Aptus and HemoCue® additionally using capillary blood (n = 506). Agreement was estimated using Bland-Altman analysis and Lin’s concordance. Usage was assessed by error occurrence and user experience. Results Mean Hb values in venous blood did not significantly differ between Aptus and HemoCue® (10.44±1.05 vs 10.56±0.93g/dl, p>0.05), but both measured higher Hb concentrations than Medonic® (9.75±0.99g/dl, p<0.0001). Lin’s coefficient between Aptus and Medonic® was rc = 0.548, between HemoCue® and Medonic® rc = 0.636. Mean bias between the PoCDs venous measurements was -0.11g/dl with limits of agreement (LoA) -1.63 and 1.40g/dl. The bias was larger for the comparisons between the Medonic® and both Aptus (0.69g/dl, LoA 0.92 and 2.31g/dl) and HemoCue® (0.81g/dl, LoA 0.17 and 1.78g/dl). ROC curves showed an AUC of 0.933 in HemoCue® and 0.799 in Aptus. Capillary Hb was higher with Aptus than HemoCue® (10.33±1.11g/dl vs 10.01±1.07g/dl, p<0.0001). Mean bias was 0.32g/dl with LoA of -1.91 and 2.54g/dl. Aptus‘ usage proved intuitive, yet time-to-results and cuvettes could be improved. Conclusion Both PoCDs showed a relatively limited bias but large LoA. Aptus and HemoCue® showed similar accuracy, while both overestimated Hb levels. Aptus showed promise, with its operation unimpaired by field conditions as well as being able to show HCT values.
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Affiliation(s)
- Stefan A. Nass
- Medical Humanities, Amsterdam-UMC—VUmc Location, Vrije Universiteit, Amsterdam, The Netherlands
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- * E-mail:
| | - Ilias Hossain
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Chilel Sanyang
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Bakary Baldeh
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Dora I. A. Pereira
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
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Ilardo C, Reynaud C, Bonneton R, Barthes J. Quality planning and control strategy for AQT90 flex Radiometer ® in point of care testing. Scand J Clin Lab Invest 2020; 80:427-432. [PMID: 32478619 DOI: 10.1080/00365513.2020.1768585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/23/2020] [Accepted: 05/10/2020] [Indexed: 06/11/2023]
Abstract
In the context of point of care testing (PoCT) and ISO 22870, internal quality control (IQC) is a crucial part of PoCT accreditation processes. Quality Control materials shall be periodically examined with a frequency that is based on the robustness of the analytical procedure and the risk of harm to the patient from an erroneous result. We propose to apply the statistical quality control (SQC) procedure to develop an individualized QC plan for AQT90 flex instrument used in PoCT. The robustness is determined by the sigma-metric and analytical goal represented by an allowable total error (TEa) is evaluated using a Varela graphic tool. A Sigma-metric SQC run size nomogram for estimating the number of patient samples between IQC events. According to the calculated robustness we can distinguish 3 groups of parameters: HCG and CRP with large sample size per event, D-Dimer and Procalcitonin with an average sample size per event and Myoglobin. NT-proBNP. and Troponin T with a limited sample size per event. In PoCT, the SQC strategy can promote more effective, and not necessarily more frequent, IQC.
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Affiliation(s)
| | | | | | - Joel Barthes
- LABOSUD laboratory (Inovie member), Montpellier, France
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Wu S, Liu F, Wang F, Huang J, Yin B, Huang M, Wang T, Wei N. Evaluation of the Automated Indirect Immunofluorescence Test for Antinuclear Antibodies. Ann Clin Lab Sci 2020; 50:282-286. [PMID: 32366571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The performance of the automated indirect immunofluorescence system was compared with the manual method for detection of antinuclear antibodies (ANA) from 354 clinical serum samples. We compared the results (negative or positive), ANA patterns, and titers for the two methods. The coincidence rates for ANA positive and negative samples were 93.4% and 98.7%, respectively. The coincidence rates for single patterns, mixed patterns, and the final titers were 85.1%, 87.6%, and 87.6%, respectively. The homogeneous, speckled, cytoplasmic, centromere, multiple nuclear dots, and nucleolar pattern coincidence rates were 79.3%, 83.0%, 87.8%, 72.7%, 50%, and 56.3%, respectively. The automated indirect immunofluorescence system had acceptable accuracy for detection of ANA.
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Affiliation(s)
- Shiji Wu
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Liu
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Wang
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jin Huang
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Botao Yin
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Huang
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Wang
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Na Wei
- Department of Clinical Laboratory, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Er H, Koyuncu-Ozyurt O, Ozhak B, Yazisiz H, Eres-Saritas Z, Cetinkaya O, Ongut G, Ogunc D. Evaluation of an Automated Yeasts Identification System for Identification of Yeast Isolates. Clin Lab 2020; 66. [PMID: 32013368 DOI: 10.7754/clin.lab.2019.190636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Invasive candidiasis is the most important health-care-associated fungal infection worldwide. In the last two decades, the cause of the increase of fungal infections is immunosuppression or serious underlying diseases. Additionally, Rhodotorula species, Blastoschizomyces capitatus, and Trichosporon species are emerging as important human pathogens in immunocompromised patients with hematological malignancy. METHODS Between January 2012 and January 2018, a total of 603 fungal organisms were isolated from blood culture samples and included in the study. All of the isolates were identified by using standard mycological methods, MALDI TOF MS system, and the Phoenix system. Sequence analysis was performed on yeasts that could not be definitively identified by using SMM and incompatible according to the results with Phoenix and MALDI-TOF MS analysis. RESULTS 603 fungal isolates including 594 Candida spp. and 9 other yeasts like species were analyzed. C. albicans was the most frequently isolated species. The results of identification by conventional methods and MALDI TOF MS were compared to the results of the Phoenix system. The observed concordance was 99.2%. The compatibility with other systems of the Phoenix system was 100%, 100%, 97.3%, 100%, and 96.9% for C. albicans, C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei, respectively. CONCLUSIONS The BD Phoenix system was found to be a simple, reliable, and effective method to identify the main species of the genus Candida in our study.
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Orchard GE, Gabriel J, Shams M, Fernando P, Satoc J, Nwokie T, Ismail F, d'Amico C. Semi-automated standardisation of melanin bleaching procedures of heavily pigmented melanocytic lesions for immunohistochemical analysis on an automated platform. Br J Biomed Sci 2019; 76:172-177. [PMID: 31144600 DOI: 10.1080/09674845.2019.1624083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/17/2019] [Indexed: 10/26/2022]
Abstract
Background: The diagnosis of heavily pigmented melanocytic lesions is problematic. This is often compounded by lack of visibility of nuclear detail of tumour cells due to physical masking by melanin pigment. Similarly, there can be colour merging of chromogenic final reaction products with melanin, making an evidence of antigenic localisation problematic. There are a number of melanin bleaching techniques available for immunohistochemical assessments.Material and methods: All methods to date have involved the bleaching of melanin as a manually performed primary step before loading subsequently bleached slides onto automated immunohistochemical platforms. Here we define a semi-automated bleaching procedure that allows full integration on one of the most widely employed automated IHC staining platforms (Roche Ventana BenchMark Ultra). The bleaching protocol was defined on the BenchMark Ultra and involved the assessment of 24 histological cases of heavily pigmented malignant melanoma lesions (13 cutaneous and 11 metastatic) routinely fixed processed and paraffin wax embedded.Results: Completion of the bleaching was assessed on H&E preparations performed following the semi-automated bleaching step and employing the Roche Ventana BenchMark Ultra machine for 60 min at 42°C. Complete immunohistochemical staining was achieved on the automated platform within 5-6 h including the bleaching step. Results were consistent across all tissue evaluated.Discussion: This data provides evidence that the hydrogen peroxide bleaching procedure can be adapted for integration on one of the most widely employed automated IHC staining platforms and as a result, improve the efficiency and reproducibility of the technique.
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Affiliation(s)
- G E Orchard
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - J Gabriel
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - M Shams
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - P Fernando
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - J Satoc
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - T Nwokie
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - F Ismail
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
| | - C d'Amico
- St. John's Histopathology, Tissue Sciences, Viapath Analytics, St. Thomas' Hospital, London, United Kingdom
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Kristiansen S, Friis-Hansen L. Validation of plasma thyroxine and triiodothyronine methods on the ADVIA Centaur ® XP. Scand J Clin Lab Invest 2019; 79:43-49. [PMID: 30777783 DOI: 10.1080/00365513.2019.1571624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/28/2018] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
Standardization programs for thyroid hormones have revealed bias between immunochemical methods and the reference method ED-ID-LC/MS. Lack of standardization between methods, suboptimal reference intervals and replacement of serum with plasma may compromise the capability of the immunochemical thyroid methods to diagnose thyroid disease. To accommodate the demand for faster turn-around times for laboratory replies, we replaced serum with plasma on some serum CE marked thyroid methods. This forced us to do on-board analytical correction for the plasma total T4 (TT4) method on ADVIA Centaur® XP. We, next, validated the capability of the ADVIA Centaur® XP thyroid methods on plasma by (1) first carrying out a prospective method comparison with the ED-ID-LC/MS reference method using collected plasma samples, (2) we verified the clinical reference intervals by analyzing collected plasma samples from healthy individuals, and (3) retrospectively compared laboratory results from two different time periods using serum TT4 and serum total triiodothyronine (TT3) versus plasma free thyroxine (FT4) and plasma TT3, respectively, to diagnose thyroid disease. The plasma FT4 method displayed a negative concentration-dependent bias against the reference method. This bias was apparently counteracted by a fitted reference interval for the plasma FT4 method. Indeed, overt hyperthyroid disease was found in 1.0% and 1.1% of the cases using serum and plasma and overt hypothyroid condition were in 1.3% and 0.6% of the cases using serum and plasma, respectively. In conclusion, the ADVIA Centaur® XP FT4 method displayed a negative bias at high plasma FT4 concentrations against the reference method, but the diagnostic performance was not compromised due to a fitted reference interval.
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Affiliation(s)
- Søren Kristiansen
- a Department of Clinical Biochemistry, North Zealand Hospital , University of Copenhagen , Hilleroed , Denmark
| | - Lennart Friis-Hansen
- a Department of Clinical Biochemistry, North Zealand Hospital , University of Copenhagen , Hilleroed , Denmark
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Adhikari EH, Macias D, Gaffney D, White S, Rogers VL, McIntire DD, Roberts SW. Diagnostic accuracy of fourth-generation ARCHITECT HIV Ag/Ab Combo assay and utility of signal-to-cutoff ratio to predict false-positive HIV tests in pregnancy. Am J Obstet Gynecol 2018; 219:408.e1-408.e9. [PMID: 29913173 DOI: 10.1016/j.ajog.2018.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/04/2018] [Accepted: 06/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND False-positive HIV screening tests in pregnancy may lead to unnecessary interventions in labor. In 2014, the Centers for Disease Control and Prevention released a new algorithm for HIV diagnosis using a fourth-generation screening test, which detects antibodies to HIV as well as p24 antigen and has a shorter window period compared with prior generations. A reactive screen requires a differentiation assay, and supplemental qualitative RNA testing is necessary for nonreactive differentiation assay. One screening test, the ARCHITECT Ag/Ab Combo assay, is described to have 100% sensitivity and >99% specificity in nonpregnant populations; however, its clinical performance in pregnancy has not been well described. OBJECTIVE The objective of the study was to determine the performance of the ARCHITECT assay among pregnant women at a large county hospital and to assess whether the relative signal-to-cutoff ratio can be used to differentiate between false-positive vs confirmed HIV infections in women with a nonreactive differentiation assay. STUDY DESIGN This is a retrospective review of fourth-generation HIV testing in pregnant women at Parkland Hospital between June 1, 2015, and Jan. 31, 2017. We identified gravidas screened using the ARCHITECT Ag/Ab Combo assay (index test), with reflex to differentiation assay. Women with reactive ARCHITECT and nonreactive differentiation assay were evaluated with a qualitative RNA assay (reference standard). We calculated sensitivity, specificity, predictive value, and false-positive rate of the ARCHITECT screening assay in our population and described characteristics of women with false-positive HIV testing vs confirmed infection. Among women with a nonreactive differentiation assay, we compared interventions among women with and without a qualitative RNA assay result available at delivery and examined relative signal-to-cutoff ratios of the ARCHITECT assay in women with false-positive vs confirmed HIV infection. RESULTS A total of 21,163 pregnant women were screened using the ARCHITECT assay, and 190 tested positive. Of these, 33 of 190 (17%) women had false-positive HIV screening tests (28 deliveries available for analysis), and 157 of 190 (83%) had confirmed HIV-1 infection (140 available for analysis). Diagnostic accuracy of the ARCHITECT HIV Ag/Ab Combo assay in our prenatal population (with 95% confidence interval) was as follows: sensitivity, 100% (97.7-100%); specificity, 99.8% (99.8-99.9%); positive likelihood ratio, 636 (453-895); negative likelihood ratio, 0.0 (NA); positive predictive value, 83% (77-88%); and false positive rate, 0.16% (0.11-0.22%), with a prevalence of 7 per 1000. Women with false-positive HIV testing were younger and more likely of Hispanic ethnicity. A qualitative RNA assay (reference standard) was performed prenatally in 24 (86%) and quantitative viral load in 22 (92%). Interventions occurred more frequently in women without a qualitative RNA assay result available at delivery, including intrapartum zidovudine (75% vs 4%, P = .002), breastfeeding delay (75% vs 8%, P = .001), and neonatal zidovudine initiation (75% vs 4%, P = .002). The ARCHITECT signal-to-cutoff ratio was significantly lower for women with false-positive HIV tests compared with those with established HIV infection (1.89 [1.27, 2.73] vs 533.65 [391.12, 737.22], respectively, P < .001). CONCLUSION While the performance of the fourth-generation ARCHITECT HIV Ag/Ab Combo assay among pregnant women is comparable with that reported in nonpregnant populations, clinical implications of using a screening test with a positive predictive value of 83% in pregnancy are significant. When the qualitative RNA assay result is unavailable, absence of risk factors in combination with an ARCHITECT HIV Ag/Ab assay S/Co ratio <5 and nonreactive differentiation assay provide sufficient evidence to support deferral of unnecessary intrapartum interventions while awaiting qualitative RNA results.
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Affiliation(s)
- Emily H Adhikari
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Devin Macias
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Donna Gaffney
- Clinical Microbiology Laboratory, Parkland Health and Hospital System, Dallas, TX
| | - Sarah White
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Vanessa L Rogers
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Donald D McIntire
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Scott W Roberts
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
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Schulze HG, Rangan S, Piret JM, Blades MW, Turner RFB. Developing Fully Automated Quality Control Methods for Preprocessing Raman Spectra of Biomedical and Biological Samples. Appl Spectrosc 2018; 72:1322-1340. [PMID: 29855196 DOI: 10.1177/0003702818778031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Spectral preprocessing is frequently required to render Raman spectra useful for further processing and analyses. The various preprocessing steps, individually and sequentially, are increasingly being automated to cope with large volumes of data from, for example, hyperspectral imaging studies. Full automation of preprocessing is especially desirable when it produces consistent results and requires minimal user input. It is therefore essential to evaluate the "quality" of such preprocessed spectra. However, relatively few methods exist to evaluate preprocessing quality, and fully automated methods for doing so are virtually non-existent. Here we provide a brief overview of fully automated spectral preprocessing and fully automated quality assessment of preprocessed spectra. We follow this with the introduction of fully automated methods to establish figures-of-merit that encapsulate preprocessing quality. By way of illustration, these quantitative methods are applied to simulated and real Raman spectra. Quality factor and quality parameter figures-of-merit resulting from individual preprocessing step quality tests, as well as overall figures-of-merit, were found to be consistent with the quality of preprocessed spectra.
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Affiliation(s)
- H Georg Schulze
- 1 Michael Smith Laboratories, The University of British Columbia, Vancouver, BC, Canada
| | - Shreyas Rangan
- 1 Michael Smith Laboratories, The University of British Columbia, Vancouver, BC, Canada
| | - James M Piret
- 1 Michael Smith Laboratories, The University of British Columbia, Vancouver, BC, Canada
- 2 Department of Chemical and Biological Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Michael W Blades
- 3 Department of Chemistry, The University of British Columbia, Vancouver, BC, Canada
| | - Robin F B Turner
- 1 Michael Smith Laboratories, The University of British Columbia, Vancouver, BC, Canada
- 3 Department of Chemistry, The University of British Columbia, Vancouver, BC, Canada
- 4 Department of Electrical and Computer Engineering, The University of British Columbia, Vancouver, BC, Canada
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13
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Stenner E, Barbati G, West N, Ben FD, Martin F, Ruscio M. Interchangeability of Procalcitonin Measurements Using the Point of Care Testing i-CHROMATM Reader and the Automated Liaison XL. Clin Lab 2018; 64:1097-1100. [PMID: 29945312 DOI: 10.7754/clin.lab.2018.180133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Our aim was to verify if procalcitonin (PCT) measurements using the new point-of-care testing i-CHROMATM are interchangeable with those of Liaison XL. METHODS One hundred seventeen serum samples were processed sequentially on a Liaison XL and i-CHROMATM. Statistical analysis was done using the Passing-Bablok regression, Bland-Altman test, and Cohen's Kappa statistic. RESULTS Proportional and constant differences were observed between i-CHROMATM and Liaison XL. The 95% CI of the mean bias% was very large, exceeding the maximum allowable TE% and the clinical reference change value. However, the concordance between methods at the clinical relevant cutoffs was strong, with the exception of the 0.25 ng/mL cutoff which was moderate. CONCLUSIONS Our data suggest that i-CHROMATM is not interchangeable with Liaison XL. However, while the strong concordance at the clinical relevant cutoffs allows us to consider i-CHROMATM a suitable option to Liaison XL to support clinicians' decision-making; nevertheless, the moderate agreement at the 0.25 ng/mL cutoff recommends caution in interpreting the data around this cutoff.
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Salinas M, Lopez-Garrigos M, Flores E, Leiva-Salinas C. Request Pattern, Pre-Analytical and Analytical Conditions of Urinalysis in Primary Care: Lessons from a One-Year Large-Scale Multicenter Study. Clin Lab 2018; 64:983-989. [PMID: 29945335 DOI: 10.7754/clin.lab.2018.171239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To study the urinalysis request, pre-analytical sample conditions, and analytical procedures. METHODS Laboratories were asked to provide the number of primary care urinalyses requested, and to fill out a questionnaire regarding pre-analytical conditions and analytical procedures. RESULTS 110 laboratories participated in the study. 232.5 urinalyses/1,000 inhabitants were reported. 75.4% used the first morning urine. The sample reached the laboratory in less than 2 hours in 18.8%, between 2 - 4 hours in 78.3%, and between 4 - 6 hours in the remaining 2.9%. 92.5% combined the use of test strip and particle analysis, and only 7.5% used the strip exclusively. All participants except one performed automated particle analysis depending on strip results; in 16.2% the procedure was only manual. CONCLUSIONS Urinalysis was highly requested. There was a lack of compliance with guidelines regarding time between micturition and analysis that usually involved the combination of strip followed by particle analysis.
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Takada N, Hirokawa M, Ohbayashi C, Nishikawa T, Itoh T, Imagawa N, Oyama T, Handa T, Hasegawa T, Sugita S, Murata A, Miyauchi A. Re-evaluation of MIB-1 immunostaining for diagnosing hyalinizing trabecular tumour of the thyroid: semi-automated techniques with manual antigen retrieval are more accurate than fully automated techniques. Endocr J 2018; 65:239-244. [PMID: 29199205 DOI: 10.1507/endocrj.ej17-0413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hyalinizing trabecular tumour (HTT) immunohistochemically shows cell membranous immunoreactivity for MIB-1. This aberrant immunoreactivity is an important factor for the diagnosis of HTT. However, fully automated stainers frequently fail to confirm the immunoreactivity. The aim of this study is to investigate the cause of false negative cell membranous immunoreactivity for MIB-1 in HTT using fully automated stainers, to determine potential reasons for the problem, and to establish methods confirming cell membranous immunoreactivity for MIB-1 in HTT. Six participating institutions examined immunoreactivity for MIB-1 in 10 HTT cases using two approaches: fully automated and semi-automated methods. In the latter, antigen retrieval was carried out using manual methods adopted for routine assays at each institute. The autostainers used included the BOND-MAX, BOND-III, Benchmark XT, and Omnis systems. Using fully automated methods, institute E showed cell membranous MIB-1 positivity in all HTT cases. In contrast, at institute D, all HTT cases were negative. The positive rates of the remaining four institutes ranged from 10% to 20%. The incidence of positive cases using semi-automated methods was 100%, 90%, 90%, 30%, 80%, and 100% at institutes A, B, C, D, E, and F, respectively. We assert that antigen retrieval should be conducted manually for diagnosis of HTT; furthermore, definitively diagnosed HTT should be prepared as the external positive control.
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Affiliation(s)
- Nami Takada
- Department of Clinical Laboratory, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Takeshi Nishikawa
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Naoko Imagawa
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Tetsunari Oyama
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Handa
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Akiko Murata
- Department of Technical Development, Genostaff Co. Ltd., Bunkyo-ku, Tokyo 113-0032, Japan
| | - Akira Miyauchi
- Department of Surgery, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
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Dargaud Y, Wolberg AS, Gray E, Negrier C, Hemker HC. Proposal for standardized preanalytical and analytical conditions for measuring thrombin generation in hemophilia: communication from the SSC of the ISTH. J Thromb Haemost 2017; 15:1704-1707. [PMID: 28656617 PMCID: PMC5680042 DOI: 10.1111/jth.13743] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Y Dargaud
- Hospices Civils de Lyon, Clinical Haemostasis Unit, Hopital Cardiologique Louis Pradel - Universite Lyon 1, Lyon, France
| | - A S Wolberg
- Department of Pathology and Laboratory Medicine, UNC, Chapel Hill, NC, USA
| | - E Gray
- Haemostasis Section, Biotherapeutics, National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, UK
| | - C Negrier
- Hospices Civils de Lyon, Clinical Haemostasis Unit, Hopital Cardiologique Louis Pradel - Universite Lyon 1, Lyon, France
| | - H C Hemker
- Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, the Netherlands
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Hardie DR, Korsman SN, Hsiao NY, Morobadi MD, Vawda S, Goedhals D. Contamination with HIV antibody may be responsible for false positive results in specimens tested on automated platforms running HIV 4th generation assays in a region of high HIV prevalence. PLoS One 2017; 12:e0182167. [PMID: 28759622 PMCID: PMC5536287 DOI: 10.1371/journal.pone.0182167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 07/13/2017] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION In South Africa where the prevalence of HIV infection is very high, 4th generation HIV antibody/p24 antigen combo immunoassays are the tests of choice for laboratory based screening. Testing is usually performed in clinical pathology laboratories on automated analysers. To investigate the cause of false positive results on 4th generation HIV testing platforms in public sector laboratories, the performance of two automated platforms was compared in a clinical pathology setting, firstly on routine diagnostic specimens and secondly on known sero-negative samples. METHODS Firstly, 1181 routine diagnostic specimens were sequentially tested on Siemens and Roche automated 4th generation platforms. HIV viral load, western blot and follow up testing were used to determine the true status of inconclusive specimens. Subsequently, known HIV seronegative samples from a single donor were repeatedly tested on both platforms and an analyser was tested for surface contamination with HIV positive serum to identify how suspected specimen contamination could be occurring. RESULTS Serial testing of diagnostic specimens yielded 163 weakly positive or discordant results. Only 3 of 163 were conclusively shown to indicate true HIV infection. Specimen contamination with HIV antibody was suspected, based on the following evidence: the proportion of positive specimens increased on repeated passage through the analysers; viral loads were low or undetectable and western blots negative or indeterminate on problem specimens; screen negative, 2nd test positive specimens tested positive when reanalysed on the screening assay; follow up specimens (where available) were negative. Similarly, an increasing number of known negative specimens became (repeatedly) sero-positive on serial passage through one of the analysers. Internal and external analyser surfaces were contaminated with HIV serum, evidence that sample splashes occur during testing. CONCLUSIONS Due to the extreme sensitivity of these assays, contamination with minute amounts of HIV antibody can cause a negative sample to test positive. Better contamination control measures are needed on analysers used in clinical pathology environments, especially in regions where HIV sero-prevalence is high.
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Affiliation(s)
- Diana Ruth Hardie
- Division of Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, South Africa
| | - Stephen N. Korsman
- Division of Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, South Africa
| | - Nei-Yuan Hsiao
- Division of Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Service, South Africa
| | - Molefi Daniel Morobadi
- National Health Laboratory Service, South Africa
- Department of Medical Microbiology and Virology, University of the Free State, Bloemfontein, South Africa
| | - Sabeehah Vawda
- National Health Laboratory Service, South Africa
- Department of Medical Microbiology and Virology, University of the Free State, Bloemfontein, South Africa
| | - Dominique Goedhals
- National Health Laboratory Service, South Africa
- Department of Medical Microbiology and Virology, University of the Free State, Bloemfontein, South Africa
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Belin SD. The human side of lab automation. Here are some best practices to break down the “silos”. MLO Med Lab Obs 2017; 49:38-40. [PMID: 29952462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Larsen PB, Storjord E, Bakke Å, Bukve T, Christensen M, Eikeland J, Haugen VE, Husby K, McGrail R, Mikaelsen SM, Monsen G, Møller MF, Nybo J, Revsholm J, Risøy AJ, Skålsvik UM, Strand H, Teruel RS, Theodorsson E. The microINR portable coagulometer: analytical quality and user-friendliness of a PT (INR) point-of-care instrument. Scand J Clin Lab Invest 2017; 77:115-121. [PMID: 28150507 DOI: 10.1080/00365513.2016.1277433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 12/04/2016] [Indexed: 06/06/2023]
Abstract
Regular measurement of prothrombin time as an international normalized ratio PT (INR) is mandatory for optimal and safe use of warfarin. Scandinavian evaluation of laboratory equipment for primary health care (SKUP) evaluated the microINR portable coagulometer (microINR®) (iLine Microsystems S.L., Spain) for measurement of PT (INR). Analytical quality and user-friendliness were evaluated under optimal conditions at an accredited hospital laboratory and at two primary health care centres (PHCCs). Patients were recruited at the outpatient clinic of the Laboratory of Medical Biochemistry, St Olav's University Hospital, Trondheim, Norway (n = 98) and from two PHCCs (n = 88). Venous blood samples were analyzed under optimal conditions on the STA-R®Evolution with STA-SPA + reagent (Stago, France) (Owren method), and the results were compared to capillary measurements on the microINR®. The imprecision of the microINR® was 6% (90% CI: 5.3-7.0%) and 6.3% (90% CI: 5.1-8.3) in the outpatient clinic and PHCC2, respectively for INR ≥2.5. The microINR® did not meet the SKUP quality requirement for imprecision ≤5.0%. For INR <2.5 at PHCC2 and at both levels in PHCC1, CV% was ≤5.0. The accuracy fulfilled the SKUP quality goal in both outpatient clinic and PHCCs. User-friendliness of the operation manual was rated as intermediate, defined by SKUP as neutral ratings assessed as neither good nor bad. Operation facilities was rated unsatisfactory, and time factors satisfactory. In conclusion, quality requirements for imprecision were not met. The SKUP criteria for accuracy was fulfilled both at the hospital and at the PHCCs. The user-friendliness was rated intermediate.
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Affiliation(s)
- Pia Bükmann Larsen
- a Department of Clinical Biochemistry , Slagelse Hospital , Slagelse, Denmark
| | - Elin Storjord
- b Department of Laboratory Medicine , Nordland Hospital , Bodø, Norway
- c Institute of Clinical Medicine, K.G. Jebsen TREC, UiT The Arctic University of Norway , Tromsø, Norway
| | - Åsne Bakke
- d Department of Endocrinology , Stavanger University Hospital , Stavanger , Norway
| | - Tone Bukve
- e Department of Multidisciplinary Laboratory Medicine and Medical Biochemistry , Akershus University Hospital , Oslo , Norway
| | - Mikael Christensen
- f Department of Clinical Biochemistry , University Hospital of Aarhus , Aarhus , Denmark
| | - Joakim Eikeland
- g Department of Clinical Biochemistry , Oslo University Hospital , Oslo , Norway
| | - Vegar Engeland Haugen
- h Department of Clinical Biochemistry , Haukeland University Hospital , Bergen , Norway
| | - Kristin Husby
- i Department of Multidisiplinary Laboratory Medicin and Medical Biochemistry , Akershus University Hospital , Oslo , Norway
| | - Rie McGrail
- f Department of Clinical Biochemistry , University Hospital of Aarhus , Aarhus , Denmark
| | | | - Grete Monsen
- k Noklus , Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Mette Fogh Møller
- l Department of Clinical Biochemistry , Herning Hospital , Herning , Denmark
| | - Jan Nybo
- m Department of Clinical Biochemistry , Aalborg University Hospital , Aalborg , Denmark
| | - Jesper Revsholm
- n Department of Clinical Biochemistry , Randers Regional Hospital , Randers , Denmark
| | - Aslaug Johanne Risøy
- k Noklus , Haraldsplass Deaconess Hospital , Bergen , Norway
- o Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway
| | | | - Heidi Strand
- i Department of Multidisiplinary Laboratory Medicin and Medical Biochemistry , Akershus University Hospital , Oslo , Norway
| | | | - Elvar Theodorsson
- p Department of Clinical Chemistry and Department of Clinical and Experimental Medicine , Linköping University , Linköping, Sweden
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Bessemans L, Jully V, de Raikem C, Albanese M, Moniotte N, Silversmet P, Lemoine D. Automated Gravimetric Calibration to Optimize the Accuracy and Precision of TECAN Freedom EVO Liquid Handler. J Lab Autom 2016; 21:693-705. [PMID: 26905719 PMCID: PMC5030733 DOI: 10.1177/2211068216632349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Indexed: 11/16/2022]
Abstract
High-throughput screening technologies are increasingly integrated into the formulation development process of biopharmaceuticals. The performance of liquid handling systems is dependent on the ability to deliver accurate and precise volumes of specific reagents to ensure process quality. We have developed an automated gravimetric calibration procedure to adjust the accuracy and evaluate the precision of the TECAN Freedom EVO liquid handling system. Volumes from 3 to 900 µL using calibrated syringes and fixed tips were evaluated with various solutions, including aluminum hydroxide and phosphate adjuvants, β-casein, sucrose, sodium chloride, and phosphate-buffered saline. The methodology to set up liquid class pipetting parameters for each solution was to split the process in three steps: (1) screening of predefined liquid class, including different pipetting parameters; (2) adjustment of accuracy parameters based on a calibration curve; and (3) confirmation of the adjustment. The run of appropriate pipetting scripts, data acquisition, and reports until the creation of a new liquid class in EVOware was fully automated. The calibration and confirmation of the robotic system was simple, efficient, and precise and could accelerate data acquisition for a wide range of biopharmaceutical applications.
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21
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Mori S, Morinaga Y, Nishimura F, Murata M, Umihata S, Sasaki D, Kaku N, Kosai K, Uno N, Taguchi J, Hasegawa H, Miyazaki Y, Yanagihara K. [Diagnostic Utilities of an Automated and Standardized DNA Quantification during Cytomegalovirus Monitoring]. Rinsho Byori 2016; 64:881-886. [PMID: 30609324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The accurate and standardized diagnosis of cytomegalovirus (CMV) infection is important for immunocom- promised patients. We prospectively evaluated the performance of an automated and standardized real-time polymerase chain reaction (PCR) -based DNA quantification for the detection of CMV. The results of PCR- based analysis were also compared with pp65 antigenemia (Ag) assay in the clinical records. The PCR- based analysis of 144 plasma samples from 26 patients with hematologic diseases detected CMV in 69 (48.0%) samples (range, <150-1.28 X 10⁴ copies/mL) while Ag detected CMV in 32(22.2%) samples (range, 1-37/50,000 cells). The number of concordant samples between the two tests was 95(66.0%). There were nine patients who had an Ag-positive period sandwiched by Ag-negative periods and, in all these patients, the Ag-positive period was completely covered by PCR-positive period. These results suggest that PCR can detect CMV more sensitively than Ag. The automated and standardized PCR for detection of CMV can support the appropriate management in patients with risks of CMV infection. [Original].
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Bustamante V, Meza P, Román JC, García P. [Evaluation of an automated streaking system of urine samples for urine cultures]. Rev Chilena Infectol 2015; 31:670-5. [PMID: 25679922 DOI: 10.4067/s0716-10182014000600005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 08/05/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Automated systems have simplified laboratory workflow, improved standardization, traceability and diminished human errors and workload. Although microbiology laboratories have little automation, in recent years new tools for automating pre analytical steps have appeared. OBJECTIVES To assess the performance of an automated streaking machine for urine cultures and its agreement with the conventional manual plating method for semi quantitative colony counts. MATERIALS AND METHODS 495 urine samples for urinary culture were inoculated in CPS® agar using our standard protocol and the PREVI™ Isola. Rates of positivity, negativity, polymicrobial growth, bacterial species, colony counts and re-isolation requirements were compared. RESULTS Agreement was achieved in 98.97% of the positive/negative results, in 99.39% of the polymicrobial growth, 99.76% of bacterial species isolated and in 98.56 % of colony counts. The need for re-isolation of colonies decreased from 12.1% to 1.1% using the automated system. DISCUSSION PREVI™ Isola's performance was as expected, time saving and improving bacterial isolation. It represents a helpful tool for laboratory automation.
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Fedchenko N, Reifenrath J. Different approaches for interpretation and reporting of immunohistochemistry analysis results in the bone tissue - a review. Diagn Pathol 2014; 9:221. [PMID: 25432701 PMCID: PMC4260254 DOI: 10.1186/s13000-014-0221-9] [Citation(s) in RCA: 413] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 11/10/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Immunohistochemistry (IHC) is a well-established, widely accepted method in both clinical and experimental parts of medical science. It allows receiving valuable information about any process in any tissue, and especially in bone. Each year the amount of data, received by IHC, grows in geometric progression. But the lack of standardization, especially on the post-analytical stage (interpreting and reporting of results), makes the comparison of the results of different studies impossible. METHODS Comprehensive PubMED literature search with a combination of search words "immunohistochemistry" and "scoring system" was performed and 773 articles describing IHC results were identified. After further manual analysis 120 articles were selected for detailed evaluation of used approaches. RESULTS Six major approaches to the interpretation and presentation of IHC analysis results were identified, analyzed and described. CONCLUSIONS The overview of the existing approaches in evaluation and interpretation of IHC data, which are provided in the article, can be used in bone tissue research and for either better understanding of existing scoring systems or developing a new one. Standard multiparametric, semiquantitative IHC scoring systems should simplify and clarify the process of interpretation and reporting of received data. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_221.
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Affiliation(s)
- Nickolay Fedchenko
- Small Animal Clinic, University of Veterinary Medicine, Foundation, Bünteweg 9, 30559, Hannover, Germany.
- Department of Pathological Anatomy and Forensic Medicine, SE "Dnipropetrovsk Medical Academy of Health Ministry of Ukraine", Dzerginskogo st. 9, 49044, Dnipropetrovsk, Ukraine.
| | - Janin Reifenrath
- Small Animal Clinic, University of Veterinary Medicine, Foundation, Bünteweg 9, 30559, Hannover, Germany.
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Priya E, Srinivasan S, Ramakrishnan S. Retrospective non-uniform illumination correction techniques in images of tuberculosis. Microsc Microanal 2014; 20:1382-1391. [PMID: 25115957 DOI: 10.1017/s1431927614012896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Image pre-processing is highly significant in automated analysis of microscopy images. In this work, non-uniform illumination correction has been attempted using the surface fitting method (SFM), multiple regression method (MRM), and bidirectional empirical mode decomposition (BEMD) in digital microscopy images of tuberculosis (TB). The sputum smear positive and negative images recorded under a standard image acquisition protocol were subjected to illumination correction techniques and evaluated by error and statistical measures. Results show that SFM performs more efficiently than MRM or BEMD. The SFM produced sharp images of TB bacilli with better contrast. To further validate the results, multifractal analysis was performed that showed distinct variation before and after implementation of illumination correction by SFM. Results demonstrate that after illumination correction, there is a 26% increase in the number of bacilli, which aids in classification of the TB images into positive and negative, as TB positivity depends on the count of bacilli.
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Affiliation(s)
- Ebenezer Priya
- 1Department of Instrumentation Engineering,Madras Institute of Technology,Anna University,Chrompet,Chennai-600044,India
| | - Subramanian Srinivasan
- 1Department of Instrumentation Engineering,Madras Institute of Technology,Anna University,Chrompet,Chennai-600044,India
| | - Swaminathan Ramakrishnan
- 2Biomedical Engineering Division,Department of Applied Mechanics,Indian Institute of Technology Madras,Chennai-600036,India
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Ito S, Ikuta K, Kato D, Shibusa K, Niizeki N, Tanaka H, Addo L, Toki Y, Hatayama M, Inamura J, Shindo M, Sasaki K, Iizuka N, Fujiya M, Torimoto Y, Kohgo Y. Non-transferrin-bound iron assay system utilizing a conventional automated analyzer. Clin Chim Acta 2014; 437:129-35. [PMID: 25072389 DOI: 10.1016/j.cca.2014.07.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/27/2014] [Accepted: 07/10/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Iron is an essential metal in the body, but its excessive accumulation causes damage in various organs through free radical production. Iron homeostasis is therefore tightly regulated. However, when iron balance collapses, such as in prolonged transfusion, transferrin (Tf) is fully saturated and non-Tf-bound iron (NTBI) appears in the serum. Monitoring serum NTBI levels is therefore crucial in the assessment of the clinical status of patients with iron overload, since NTBI is associated with cellular and organ damage. Several methods for NTBI determination have been reported, but these are extremely complicated and very few laboratories can quantify NTBI at present. METHODS We established a novel assay system utilizing automated analyzers that are widely used in clinical laboratories for diagnostic testing. In this assay, NTBI is chelated by nitrilotriacetic acid (NTA), after which the iron is reduced and transferred to nitroso-PSAP, a chromogen. RESULTS The assay shows excellent linearity, reproducibility, and compatibility with HPLC, one of the most reliable conventional methods for NTBI quantification. CONCLUSIONS Our novel method for NTBI measurement is high-throughput and may be a useful and powerful tool in the study of the physiological and clinical importance of NTBI.
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Affiliation(s)
- Satoshi Ito
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Katsuya Ikuta
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Daisuke Kato
- Research and Development Department, Shino-Test Corporation, Sagamihara, Kanagawa, Japan
| | - Kotoe Shibusa
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Noriyasu Niizeki
- Department of Medical Laboratory and Blood Center, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Hiroki Tanaka
- Department of Gastrointestinal Immunology and Regenerative Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Lynda Addo
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasumichi Toki
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Mayumi Hatayama
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Junki Inamura
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Motohiro Shindo
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Katsunori Sasaki
- Department of Gastrointestinal Immunology and Regenerative Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Naomi Iizuka
- Research and Development Department, Shino-Test Corporation, Sagamihara, Kanagawa, Japan
| | - Mikihiro Fujiya
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yoshihiro Torimoto
- Oncology Center, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Yutaka Kohgo
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Saieg MA, Motta TH, Fodra ME, Scapulatempo C, Longatto-Filho A, Stiepcich MMA. Automated screening of conventional gynecological cytology smears: feasible and reliable. Acta Cytol 2014; 58:378-82. [PMID: 25195537 DOI: 10.1159/000365944] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/02/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We tested the ability of automated screening in processing conventional gynecological cytology smears and its efficacy in assessing sample adequacy and stratifying cases for risk of malignancy. STUDY DESIGN Cases were retrospectively selected, including unsatisfactory samples and slides with various sorts of artifacts. Automated screening was performed using the FocalPoint GS Imaging System (Becton Dickinson, Franklin Lakes, N.J., USA), with classification into five quintiles. For agreement purposes, cases were grouped into high risk for malignancy (quintiles 1 and 2) and low risk for malignancy (quintiles 3, 4 and 5). RESULTS A total of 120 cases (median age 37.5 years, range 18-85) were included in the study. Eighty-three cases (69.2%) could be successfully classified into quintiles. When divided by risk, 31 cases were placed in the high-risk and 52 in the low-risk group. The overall sensitivity and specificity of the automated analysis was 100 and 70.3%, respectively. CONCLUSIONS Automated analysis could analyze the majority of conventional smears, including one case previously screened as unsatisfactory. All malignant and high-grade lesions were correctly classified into the high-risk group. Broad use of this automation system could potentially decrease screening time and augment the efficacy in detecting precursor neoplastic changes in cervical cytology smears.
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Patel N. Automation in hematology. Here's the state of the art in 2014. MLO Med Lab Obs 2014; 46:6-11. [PMID: 24527520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Lu J, Pulsipher BS, Grenache DG. An automated method for the measurement of total protein in homogenates of intestinal mucosa. Clin Chim Acta 2013; 421:59. [PMID: 23470426 DOI: 10.1016/j.cca.2013.02.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 02/22/2013] [Accepted: 02/25/2013] [Indexed: 11/16/2022]
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Ivanov AM, Zhdanov KV, Krivoruchko AA, Ivoĭlov OO. [Perspective technologies and researches in the areaof medical laboratory diagnostics]. Voen Med Zh 2013; 334:54-57. [PMID: 24000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The main principles of organisation of medical laboratory diagnostics are efficiency of analysis, mobility of laboratory services and quality of researches. These goals can be achieved by the use of portative laboratory analizers, by automation and computerization of the laboratorial service, by development and adoption of new laboratory technologies, integrating different methods and types of research. It is necessary to pay attention to the problem of NPT and indication of pathogenic germs. Priority areas of medical laboratory diagnostics development are: development and use of portative laboratory analyzers; development of chemical, that help to speed up and cheapen researches, improve effectiveness of laboratory diagnostics of infections and indications of pathogenic and other germ; development of new, more sensitive, specific, but simple methods of laboratory analysis; development of complex methods and types of researches, further implementation of methods and researches with different principles of action; development and implementation of new methods of NPT results recording; automation and computerization of the laboratorial diagnostics.
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Abstract
BACKGROUND Protecting the safety of blood transfusion is the top priority of transfusion service laboratories. Pretransfusion testing is a critical element of the entire transfusion process to enhance vein-to-vein safety. Human error associated with manual pretransfusion testing is a cause of transfusion-related mortality and morbidity and most human errors can be eliminated by automated systems. However, the uptake of automation in transfusion services has been slow and many transfusion service laboratories around the world still use manual blood group and antibody screen (G&S) methods. STUDY DESIGN AND METHODS The goal of this study was to compare error potentials of commonly used manual (e.g., tiles and tubes) versus automated (e.g., ID-GelStation and AutoVue Innova) G&S methods. Routine G&S processes in seven transfusion service laboratories (four with manual and three with automated G&S methods) were analyzed using failure modes and effects analysis to evaluate the corresponding error potentials of each method. RESULTS Manual methods contained a higher number of process steps ranging from 22 to 39, while automated G&S methods only contained six to eight steps. Corresponding to the number of the process steps that required human interactions, the risk priority number (RPN) of the manual methods ranged from 5304 to 10,976. In contrast, the RPN of the automated methods was between 129 and 436 and also demonstrated a 90% to 98% reduction of the defect opportunities in routine G&S testing. CONCLUSION This study provided quantitative evidence on how automation could transform pretransfusion testing processes by dramatically reducing error potentials and thus would improve the safety of blood transfusion.
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Affiliation(s)
- Susan F South
- Ortho-Clinical Diagnostics, Raritan, New Jersey 08869, USA
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Poller L, Ibrahim S, Keown M, Pattison A, Jespersen J. The prothrombin time/international normalized ratio (PT/INR) Line: derivation of local INR with commercial thromboplastins and coagulometers--two independent studies. J Thromb Haemost 2011; 9:140-8. [PMID: 20942851 DOI: 10.1111/j.1538-7836.2010.04109.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The WHO scheme for prothrombin time (PT) standardization has been limited in application, because of its difficulties in implementation, particularly the need for mandatory manual PT testing and for local provision of thromboplastin international reference preparations (IRP). METHODS The value of a new simpler procedure to derive international normalized ratio (INR), the PT/INR Line, based on only five European Concerted Action on Anticoagulation (ECAA) calibrant plasmas certified by experienced centres has been assessed in two independent exercises using a range of commercial thromboplastins and coagulometers. INRs were compared with manual certified values with thromboplastin IRP from expert centres and in the second study also with INRs from local ISI calibrations. RESULTS In the first study with the PT/INR Line, 8.7% deviation from certified INRs was reduced to 1.1% with human reagents, and from 7.0% to 2.6% with rabbit reagents. In the second study, deviation was reduced from 11.2% to 0.4% with human reagents by both local ISI calibration and the PT/INR Line. With rabbit reagents, 10.4% deviation was reduced to 1.1% with both procedures; 4.9% deviation was reduced to 0.5% with bovine/combined reagents with local ISI calibrations and to 2.9% with the PT/INR Line. Mean INR dispersion was reduced with all thromboplastins and automated systems using the PT/INR Line. CONCLUSIONS The procedure using the PT/INR Line provides reliable INR derivation without the need for WHO ISI calibration across the range of locally used commercial thromboplastins and automated PT systems included in two independent international studies.
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Affiliation(s)
- L Poller
- EAA Central Facility, Faculty of Life Sciences, University of Manchester, Manchester, UK.
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Abstract
BACKGROUND Hyperglycemia in the adult inpatient population remains a topic of intense study in U.S. hospitals. Most hospitals have established glycemic control programs but are unable to determine their impact. The 2009 Remote Automated Laboratory System (RALS) Report provides trends in glycemic control over 4 years to 576 U.S. hospitals to support their effort to manage inpatient hyperglycemia. METHODS A proprietary software application feeds de-identified patient point-of-care blood glucose (POC-BG) data from the Medical Automation Systems RALS-Plus data management system to a central server. Analyses include the number of tests and the mean and median BG results for intensive care unit (ICU), non-ICU, and each hospital compared to the aggregate of the other hospitals. RESULTS More than 175 million BG results were extracted from 2006-2009; 25% were from the ICU. Mean range of BG results for all inpatients in 2006, 2007, 2008, and 2009 was 142.2-201.9, 145.6-201.2, 140.6-205.7, and 140.7-202.4 mg/dl, respectively. The range for ICU patients was 128-226.5, 119.5-219.8, 121.6-226.0, and 121.1-217 mg/dl, respectively. The range for non-ICU patients was 143.4-195.5, 148.6-199.8, 145.2-201.9, and 140.7-203.6 mg/dl, respectively. Hyperglycemia rates of >180 mg/dl in 2008 and 2009 were examined, and hypoglycemia rates of <40 mg/dl (severe) and <70 mg/dl (moderate) in both 2008 and 2009 were calculated. CONCLUSIONS From these data, hospitals can determine the current state of glycemic control in their hospital and in comparison to other hospitals. For many, glycemic control has improved. Automated POC-BG data management software can assist in this effort.
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Affiliation(s)
| | - Denise Zito
- Medical Automation Systems, Charlottesville, Virginia
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Abstract
In an article by Anderson and colleagues in this issue of Journal of Diabetes Science and Technology, the 2009 Remote Automated Laboratory System Report describes the use of a proprietary software application in 576 United States hospital benchmark subscribers, permitting blood glucose surveillance. The Program for the Treatment of the Hospitalized Diabetic Patient was initiated at Edith Wolfson Medical Center in 2007 and included an automated glucometer in each inpatient department. Results are transmitted automatically to a central database. Importantly, these data interface with the patient electronic medical record, permitting accurate patient follow-up within and between hospitalizations; the patient response-to-treatment evaluation; identification of secular glucose trends; and interdepartmental and interinstitutional comparisons. The data have been associated with a significant reduction in random blood glucose values. In Israel, the National Diabetes Council has recommended the use of automated institutional glucometers in all hospitals.
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Affiliation(s)
- Mona Boaz
- Epidemiology and Research Unit, E. Wolfson Medical Center, Holon, Israel.
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Schoenfeld H, Pretzel KJ, von Heymann C, Neuner B, Kalus U, Kiesewetter H, Pruss A. Validation of a hospital-laboratory workstation for immunohematologic methods. Transfusion 2010; 50:26-31. [PMID: 19709392 DOI: 10.1111/j.1537-2995.2009.02359.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The FREELYS Nano system (Diagast) is a manual workstation for ABO/D grouping, Rh phenotyping, K typing, and antibody screening (ABS) for immunoglobulin G (IgG) antibodies only and works with the erythrocyte-magnetized technology (EMT). The principle of EMT is based on magnetization of red blood cells and avoids centrifugation and washing steps. STUDY DESIGN AND METHODS A total of 304 samples were tested with our routine blood bank methods, 100 samples for ABO/D grouping, 196 samples (100 at first evaluation, 96 at second evaluation) for Rh phenotyping and K typing (PK7200, Olympus), and 108 samples for ABS (DiaMed). All samples were tested in parallel with the FREELYS Nano. RESULTS We found a 100% concordance between the observed (FREELYS Nano) and the expected (Olympus PK7200) results for ABO/D grouping in all 100 samples. For Rh phenotyping and K tests, in 24 of 100 samples false-positive reactions were observed in the first evaluation by the FREELYS Nano. After changing the test kit batch for Rh phenotyping by the manufacturer, a complete concordance in Rh phenotyping and K tests was observed in a second evaluation. For ABS, the FREELYS Nano showed in 4 of 108 samples (3.7%) false-negative reactions for IgG antibodies (two anti-K, one anti-E, one anti-C(w)), and one (0.9%) false-positive reaction. CONCLUSIONS The FREELYS Nano is reliably suited to ABO/D grouping, Rh phenotyping, and K testing. The rate of false-negative reactions for IgG antibodies should be reduced.
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Affiliation(s)
- Helge Schoenfeld
- Department of Anesthesiology and Intensive Care Medicine and the Institute of Transfusion Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Medovyĭ VS, Parpara AA, Piatnitskiĭ AM, Sokolinskiĭ BZ. [Robotized microscopy introduces the test quality standard for blood smears]. Klin Lab Diagn 2009:40-44. [PMID: 19882868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The authors consider recommendations on blood smear microscopic tests, possibilities of implementing these recommendations when manual microscopy and automatic microscopy complexes (AMC) are used. Whether one may switch over from the recommendations to the quality standard implemented in practice when AMCs are applied is discussed. Conditions for effectively using AMC models with different functions, performance, and cost are considered.
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