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Establishing the TSH reference intervals for healthy adults aged over 70 years: the Australian ASPREE cohort study. 确定 70 岁以上健康成年人的促甲状腺激素参考区间:澳大利亚 ASPREE 队列研究。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-03 DOI: 10.1515/cclm-2024-0848
Cammie Tran, Duncan J Topliss, Hans G Schneider, Ego Seeman, Daniel Clayton-Chubb, Johannes T Neumann, Nadira Kakoly, Zhen Zhou, Sultana Monira Hussain, Amanda J Rickard, David P Q Clark, Raj C Shah, Robyn L Woods, John J McNeil

Objectives: As thyroid disorders are common amongst the elderly, this study aims to evaluate the reference interval (RI) for thyroid stimulating hormone (TSH) in healthy adults aged 70 years and over.

Methods: A proposed RI was determined from the Australian participants of the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial. Participants had no history of cardiovascular disease, thyroid cancer, dementia, or life-threatening illnesses. Participants prescribed with any thyroid-related medication at baseline were excluded. TSH levels were measured using a commercial chemiluminescence microparticle immunoassay. The RI was determined using the middle 95th percentile of the logarithmic transformed data of baseline TSH. Cox proportional hazard regression models were used to validate the RI by assessing disease incidence over time.

Results: A total of 10,995 participants had baseline TSH measures. Median (IQR) age was 73.9 (71.8-77.3) years. We propose a RI of 0.34-3.75 mU/L. TSH levels did not differ by age or sex. At baseline, there was no association between symptoms associated with thyroid disease and levels of TSH. Over the follow-up period of up to 11 years, no association was seen between baseline TSH levels and relevant disease outcomes for participants within the RI.

Conclusions: From a group of initially healthy, community-dwelling adults aged >=70 years, we propose a RI of TSH to best represent euthyroidism. This concentration was not associated with an increased risk of thyroid related symptoms or outcomes, confirming its appropriateness for clinical use.

研究目的由于甲状腺疾病在老年人中很常见,本研究旨在评估 70 岁及以上健康成年人促甲状腺激素(TSH)的参考区间(RI):方法:根据 "ASPirin in Reducing Events in the Elderly (ASPREE) "随机试验的澳大利亚参与者确定建议的参考区间。参与者无心血管疾病、甲状腺癌、痴呆或危及生命的疾病史。基线时服用任何甲状腺相关药物的参试者均被排除在外。使用商用化学发光微粒子免疫测定法测定 TSH 水平。使用基线 TSH 对数变换数据的中间 95 百分位数确定 RI。通过评估随时间变化的疾病发病率,使用考克斯比例危险回归模型来验证 RI:共有 10995 名参与者进行了 TSH 基线测量。中位(IQR)年龄为 73.9(71.8-77.3)岁。我们提出的 RI 为 0.34-3.75 mU/L。TSH 水平没有年龄或性别差异。基线时,甲状腺疾病相关症状与 TSH 水平之间没有关联。在长达11年的随访期间,在RI范围内的参与者的基线TSH水平与相关疾病结果之间未发现任何关联:从一组年龄大于等于 70 岁、最初健康、居住在社区的成年人中,我们提出了最能代表甲状腺功能亢进的促甲状腺激素 RI。该浓度与甲状腺相关症状或结果的风险增加无关,因此适合临床使用。
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引用次数: 0
Absolute quantitation of human serum cystatin C: candidate reference method by 15N-labeled recombinant protein isotope dilution UPLC-MS/MS. 利用 15N 标记重组蛋白同位素稀释 UPLC-MS/MS 绝对定量人血清胱抑素 C:候选参考方法。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-27 DOI: 10.1515/cclm-2024-0300
Qiaoxuan Zhang, Min Zhan, Xiongqiang Peng, Xing Jin, Jun Yan, Pengwei Zhang, Junhua Zhuang, Liqiao Han, Xianzhang Huang

Objectives: Serum cystatin C (CysC) is a reliable and ideal endogenous marker for accurately assessing early changes in glomerular filtration rate (GFR), surpassing the limitations of creatinine-based estimated GFR. To improve the precision of GFR calculation, the development of strategies for accurately measuring serum CysC is crucial.

Methods: In this study, the full-length CysC pure product and fully recombinant 15N-labeled CysC internal standard were subjected to protein cleavage. Subsequently, an LC-MS/MS method was developed for the absolute quantification of serum CysC. The traceability of the method was assigned calibrator using the amino acid reference measurement procedure (RMP). It involved calibrating the instrument using an amino acid reference material with known amino acid concentrations for calibration and comparison purposes.

Results: The total imprecision of the method was determined to be ≤8.2 %, and a lower functional limit of quantification (LLoQ) was achieved. The recoveries ranged from 97.36 to 103.26 %. The relative bias between this candidate RMP for measurement of ERM-DA471-IFCC and the target value was 1.74 %. The linearity response was observed within the concentration range of 0.21-10.13 mg/L, with a high R2 value of 0.999. The results obtained using our method was consistent with those obtained using other certified RMPs.

Conclusions: With the establishment of this highly selective and accurate serum CysC measurement method, it is now possible to assess the correlation between immunoassay results of serum CysC and the intended target when discrepancies are suspected in the clinical setting.

目的:血清胱抑素 C(CysC)是准确评估肾小球滤过率(GFR)早期变化的可靠而理想的内源性标记物,它超越了基于肌酐估算的 GFR 的局限性。为了提高 GFR 计算的精确度,开发精确测量血清 CysC 的策略至关重要:本研究对全长 CysC 纯品和全重组 15N 标记 CysC 内标进行了蛋白裂解。随后,建立了一种用于绝对定量血清 CysC 的 LC-MS/MS 方法。该方法的溯源性采用氨基酸参考测量程序(RMP)指定校准器。这包括使用已知氨基酸浓度的氨基酸参考物质校准仪器,以达到校准和比较的目的:结果:该方法的总精密度≤8.2%,达到了定量功能下限(LLoQ)。回收率为 97.36%至 103.26%。测定 ERM-DA471-IFCC 的候选 RMP 与目标值之间的相对偏差为 1.74%。在 0.21-10.13 mg/L 浓度范围内线性响应良好,R2 值高达 0.999。使用我们的方法得出的结果与使用其他经认证的 RMP 得出的结果一致:结论:随着这种高选择性、高精度血清 CysC 测量方法的建立,当临床怀疑血清 CysC 与预期目标不一致时,就可以评估免疫测定结果之间的相关性。
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引用次数: 0
Targeted MRM-analysis of plasma proteins in frozen whole blood samples from patients with COVID-19: a retrospective study. 对 COVID-19 患者冷冻全血样本中的血浆蛋白进行靶向 MRM 分析:一项回顾性研究。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-26 DOI: 10.1515/cclm-2024-0800
Anna E Bugrova, Polina A Strelnikova, Alexey S Kononikhin, Natalia V Zakharova, Elizaveta O Diyachkova, Alexander G Brzhozovskiy, Maria I Indeykina, Ilya N Kurochkin, Alexander V Averyanov, Evgeny N Nikolaev

Objectives: The COVID-19 pandemic has exposed a number of key challenges that need to be urgently addressed. Mass spectrometric studies of blood plasma proteomics provide a deep understanding of the relationship between the severe course of infection and activation of specific pathophysiological pathways. Analysis of plasma proteins in whole blood may also be relevant for the pandemic as it requires minimal sample preparation.

Methods: The frozen whole blood samples were used to analyze 203 plasma proteins using multiple reaction monitoring (MRM) mass spectrometry and stable isotope-labeled peptide standards (SIS). A total of 131 samples (FRCC, Russia) from patients with mild (n=41), moderate (n=39) and severe (n=19) COVID-19 infection and healthy controls (n=32) were analyzed.

Results: Levels of 94 proteins were quantified and compared. Significant differences between all of the groups were revealed for 44 proteins. Changes in the levels of 61 reproducible COVID-19 markers (SERPINA3, SERPING1, ORM1, HRG, LBP, APOA1, AHSG, AFM, ITIH2, etc.) were consistent with studies performed with serum/plasma samples. The best-performing classifier built with 10 proteins achieved the best combination of ROC-AUC (0.97-0.98) and accuracy (0.90-0.93) metrics and distinguished patients from controls, as well as patients by severity.

Conclusions: Here, for the first time, frozen whole blood samples were used for proteomic analysis and assessment of the status of patients with COVID-19. The results obtained with frozen whole blood samples are consistent with those from plasma and serum.

目标:COVID-19 大流行暴露了一些亟待解决的关键挑战。血浆蛋白质组学的质谱研究有助于深入了解严重感染过程与特定病理生理途径激活之间的关系。分析全血中的血浆蛋白也可能与大流行病有关,因为它只需最少的样本制备:方法:使用多重反应监测(MRM)质谱法和稳定同位素标记肽标准(SIS)对冷冻全血样本中的 203 种血浆蛋白进行分析。共分析了 131 份样本(俄罗斯 FRCC),分别来自轻度(41 份)、中度(39 份)和重度(19 份)COVID-19 感染者和健康对照组(32 份):结果:对 94 种蛋白质的水平进行了量化和比较。结果:对 94 种蛋白质的水平进行了量化和比较。61种可重复的COVID-19标志物(SERPINA3、SERPING1、ORM1、HRG、LBP、APOA1、AHSG、AFM、ITIH2等)水平的变化与血清/血浆样本的研究结果一致。用 10 种蛋白质构建的分类器表现最佳,达到了 ROC-AUC (0.97-0.98)和准确度(0.90-0.93)指标的最佳组合,并能区分患者和对照组,以及不同严重程度的患者:本文首次使用冷冻全血样本进行蛋白质组分析,并对 COVID-19 患者的状况进行评估。使用冷冻全血样本得出的结果与血浆和血清得出的结果一致。
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引用次数: 0
Synovial fluid D-lactate - a pathogen-specific biomarker for septic arthritis: a prospective multicenter study. 滑膜液 D-乳酸盐--化脓性关节炎的病原体特异性生物标志物:一项前瞻性多中心研究。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-26 DOI: 10.1515/cclm-2024-0556
Svetlana Karbysheva, Paula Morovic, Petri Bellova, Marvin Sven Berger, Maik Stiehler, Sebastian Meller, Stephanie Kirschbaum, Philippe Lindenlaub, Armin Zgraggen, Michael Oberle, Michael Fuchs, Carsten Perka, Andrej Trampuz, Anna Conen

Objectives: The performance of synovial fluid biomarker D-lactate to diagnose septic arthritis (SA) and differentiate it from crystal-induced arthritis (CA), other non-infectious rheumatic joint diseases (RD) and osteoarthrosis (OA) was evaluated.

Methods: Consecutive adult patients undergoing synovial fluid aspiration due to joint pain were prospectively included in different German and Swiss centers. Synovial fluid was collected for culture, leukocyte count and differentiation, detection of crystals, and D-lactate concentration. Youden's J statistic was used to determine optimal D-lactate cut-off value on the receiver operating characteristic (ROC) curve by maximizing sensitivity and specificity.

Results: In total 231 patients were included. Thirty-nine patients had SA and 192 aseptic arthritis (56 patients with OA, 68 with CA, and 68 with RD). The median concentration of synovial fluid D-lactate was significantly higher in patients with SA than in those with OA, CA, and RD (p<0.0001, p<0.0001 and p<0.0001, respectively). The optimal cut-off of synovial fluid D-lactate to diagnose SA was 0.033 mmol/L with a sensitivity of 92.3 % and specificity of 85.4 % independent of previous antimicrobial treatment. Sensitivity and specificity of synovial fluid leukocyte count at a cut-off of 20,000 cells/µL was 81.1 % and 80.8 %, respectively.

Conclusions: Synovial fluid D-lactate showed a high performance for diagnosing SA which was superior to synovial fluid leukocyte count. Given its high sensitivity and specificity, it serves as both an effective screening tool for SA and a differentiator between SA and RD, especially CA.

目的:评估滑液生物标志物 D-乳酸盐诊断化脓性关节炎(SA)并与晶体诱导性关节炎(CA)、其他非感染性风湿性关节病(RD)和骨关节病(OA)鉴别的性能:方法:在德国和瑞士的不同中心对因关节疼痛而接受滑液抽吸的连续成年患者进行了前瞻性研究。采集的滑膜液进行培养、白细胞计数和分化、晶体检测以及 D-乳酸盐浓度检测。通过最大限度地提高灵敏度和特异性,采用尤登 J 统计法确定接收者操作特征曲线(ROC)上的最佳 D-乳酸盐临界值:结果:共纳入 231 名患者。39名患者患有SA,192名患者患有无菌性关节炎(56名患者患有OA,68名患者患有CA,68名患者患有RD)。SA患者滑膜液D-乳酸的中位浓度明显高于OA、CA和RD患者(p结论:滑膜液 D-乳酸在诊断 SA 方面表现出较高的性能,优于滑膜液白细胞计数。鉴于其灵敏度和特异性都很高,它既是筛查 SA 的有效工具,也是区分 SA 和 RD(尤其是 CA)的指标。
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引用次数: 0
Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories. 对 Lippi 等人的评论EFLM 实验室应急准备工作组(TF-PLE)关于加强医学实验室网络安全和管理网络攻击的建议。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-26 DOI: 10.1515/cclm-2024-1093
Ivana Lapić, Dunja Rogić, Mirjana Fuček, Ines Alpeza Viman
{"title":"Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories.","authors":"Ivana Lapić, Dunja Rogić, Mirjana Fuček, Ines Alpeza Viman","doi":"10.1515/cclm-2024-1093","DOIUrl":"https://doi.org/10.1515/cclm-2024-1093","url":null,"abstract":"","PeriodicalId":10390,"journal":{"name":"Clinical chemistry and laboratory medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical value of smear review of flagged samples analyzed with the Sysmex XN hematology analyzer. 使用 Sysmex XN 血液分析仪对标记样本进行涂片审查的临床价值。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-25 DOI: 10.1515/cclm-2024-0973
Anne Winther-Larsen, Else Marie Vestergaard, Anders Abildgaard

Objectives: A smear review is typically made in flagged differential counts performed with hematology analyzers although the clinical value of such reviews is uncertain. Therefore, we evaluated the differences in differential counts between Sysmex XN-9000 and a smear review in flagged samples. Furthermore, the clinical value of blasts identified was investigated.

Methods: Data on all differential counts performed in a two-year period were identified at two laboratories. In patients with blasts, the electronic health record was reviewed. Agreement between automated and manual differential counts was evaluated by Bland-Altman plots. Concordance between the two methods categorized according to reference intervals was evaluated and adjusted for irrelevant non-concordance caused by random analytical error.

Results: In total, 5,500 flagged differential counts were identified from 4,092 patients. A good agreement between the automated and manual differential count was found for all cell types (-0.480 × 109/L to 0.297 × 109/L). The concordance between the two methods was excellent for all cell types, except for monocytes (82 %) where the automated estimates were higher than the manual in 19 % of samples. Blasts were identified in 241 (1 %) of smear reviews. Acute leukemia was diagnosed in 13 (5 %) patients, and only in one patient contributed the detection of blasts to the suspicion of acute leukemia.

Conclusions: Our findings indicate that routine smear review of all flagged samples do not contribute with additional, significant information. After local validation and dialogue with clinical departments, such reviews may potentially be omitted to increase cost-effectiveness and reduce turn-around-time.

目的:使用血液分析仪进行标记差值计数时通常会进行涂片复核,但这种复核的临床价值尚不确定。因此,我们评估了 Sysmex XN-9000 和涂片复核在标记样本中差值计数的差异。此外,我们还研究了所发现的胚泡的临床价值:方法:对两家实验室两年内进行的所有差分计数数据进行了鉴定。方法:对两家实验室两年内进行的所有差值计数数据进行了鉴定,并对有囊泡的患者的电子病历进行了审查。通过 Bland-Altman 图评估自动差分计数与人工差分计数之间的一致性。对根据参考区间分类的两种方法之间的一致性进行了评估,并对随机分析误差导致的不相关不一致进行了调整:结果:共从 4092 名患者中识别出 5500 个标记的差异计数。在所有细胞类型中,自动差分计数与人工差分计数的一致性都很好(-0.480 × 109/L 至 0.297 × 109/L)。除单核细胞(82%)外,两种方法在所有细胞类型中的一致性都很好,其中有 19% 的样本的自动估计值高于人工估计值。在 241 例(1%)涂片复查中发现了芽胞。有 13 名患者(5%)被诊断为急性白血病,只有一名患者因检测到血泡而被怀疑为急性白血病:我们的研究结果表明,对所有标记样本进行常规涂片检查并不能提供额外的重要信息。结论:我们的研究结果表明,对所有标记样本进行常规涂片检查并不能提供额外的重要信息。经过当地验证并与临床科室沟通后,此类检查有可能被省略,以提高成本效益并缩短周转时间。
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引用次数: 0
A simple gatekeeping intervention improves the appropriateness of blood urea nitrogen testing. 简单的把关干预措施可提高血尿素氮检测的适当性。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-25 DOI: 10.1515/cclm-2024-0937
Luigi Devis, Emilie Catry, Régis Debois, Isabelle Michaux, Patrick M Honore, Eric Pinck, Frédéric Foret, François Mullier, Mélanie Closset
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引用次数: 0
New concept for control material in glucose point-of-care-testing for external quality assessment schemes. 用于外部质量评估计划的葡萄糖定点检测控制材料新概念。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-24 DOI: 10.1515/cclm-2024-0822
Patricia Kaiser, Udo Kramer, Hannah Rosenthal, Christian Genz, Nathalie Weiss, Ingo Schellenberg, Michael Spannagl

Objectives: Until now, the external quality assessment (EQA) of glucose point-of-care testing (POCT) has lacked a high quality, suitable and commutable control material to assess measurement accuracy. Here we present a concept for determining the accuracy of glucose measurements, which uses human whole blood and does not require stabilising agents.

Methods: This new generation of quality control samples uses a bead that contains a specific amount of glucose. The bead is then dissolved in a whole blood matrix by the EQA participant immediately before the POCT. We analysed its suitability as an EQA material with respect to its reproducibility, homogeneity and stability, and applied it in an EQA pilot study. The glucose target value was determined using the reference measurement procedure and served as an evaluation criterion for the accuracy of the EQA survey results.

Results: The homogeneity and stability of the new control material fulfilled the quality requirements of ISO 17043. Based on the reference measurement value for glucose, the results of the pilot EQA scheme showed a pass rate of 84.6 % for the participating POCT devices. The acceptance limit was a 15 % permitted deviation from the target value according to Rili-BAEK. All of the device collectives deviated from the target value by 0-4.4 % with the exception of one device type, which deviated by 21 %.

Conclusions: The new concept offers, for the first-time, whole blood-based trueness controls for glucose POCT analysis for external quality assurance. The concept does not require the addition of any stabilising reagent and is easy to use.

目的:迄今为止,葡萄糖床旁检测(POCT)的外部质量评估(EQA)一直缺乏高质量、合适且可通用的对照材料来评估测量的准确性。在此,我们提出了一个确定葡萄糖测量准确性的概念,它使用人体全血,不需要稳定剂:方法:这种新一代的质量控制样本使用一种含有特定量葡萄糖的微珠。方法:新一代质控样本使用含有特定量葡萄糖的微珠,然后由 EQA 参与者在 POCT 检测前将微珠溶解在全血基质中。我们分析了它作为 EQA 材料在重现性、均匀性和稳定性方面的适用性,并将其应用于 EQA 试验研究。血糖目标值通过参考测量程序确定,并作为 EQA 调查结果准确性的评估标准:结果:新对照材料的均匀性和稳定性符合 ISO 17043 的质量要求。根据葡萄糖的参考测量值,试点 EQA 计划的结果显示,参与试点的 POCT 设备的合格率为 84.6%。根据 Rili-BAEK 的规定,接受限值是允许偏离目标值的 15%。除一种设备偏离目标值 21% 外,其他所有设备均偏离目标值 0-4.4%:新概念首次为葡萄糖 POCT 分析提供了基于全血的真实性控制,以确保外部质量。该概念无需添加任何稳定试剂,使用方便。
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引用次数: 0
Agreement of lymphocyte subsets detection permits reference intervals transference between flow cytometry systems: direct validation using established reference intervals. 淋巴细胞亚群检测的一致性允许参考区间在流式细胞仪系统之间转移:使用既定参考区间进行直接验证。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-23 DOI: 10.1515/cclm-2024-0603
Mei Liu, Sihua Yu, Siyao Li, Xiaowen Yu, Heqiao Wang, Jiaqi Wang, Pan Wang, Zihan Su, Yajing Fu, Yongjun Jiang, Min Zhao, Zining Zhang, Hong Shang

Objectives: With the increasing demand and application of lymphocyte subsets detection in clinical laboratories, different single-platform flow cytometer (FCM) systems have been developed. There is an urgent need to establish the reference intervals (RIs) for different single-platform FCMs and transferring them from one FCM system to another provides a much more feasible and convenient approach. This study aimed to explore the transferability of RIs for lymphocyte subsets across different flow cytometry platforms.

Methods: We first conducted the pairwise method comparison across four FCM platforms, including NovoCyte, BriCyteE6, DxFLEX, and FACSCantoII systems. Next, the transferability of RIs of lymphocyte subsets was evaluated. Furthermore, we conducted the RIs transference based on the FACSCantoII system, BriCyteE6 system and DxFLEX system, except for NK cells. The transferred RIs were further verified by calculating the bias (CV) between the established ones.

Results: The results of lymphocyte subsets detection based on the NovoCyte, BriCyteE6, DxFLEX, and FACSCantoII systems were comparable and it was feasible to transfer the RIs of lymphocyte subsets detected by the four FCM systems. The RIs of lymphocyte subsets detection using FACSCantoII, DxFLEX, and BriCyteE6 systems were established. Upon transferring the RIs of lymphocyte subsets from the FACSCantoII system to the BriCyteE6 system, and DxFLEX system except for NK cells, the CV between the transferred RIs and the established ones was below 20 % for all parameters.

Conclusions: The present study illustrated that the RIs of lymphocyte subsets could be transferred across different flow cytometry systems except for NK cells with different definition strategies.

目的:随着临床实验室对淋巴细胞亚群检测的需求和应用日益增多,不同的单平台流式细胞仪(FCM)系统应运而生。建立不同单平台流式细胞仪的参考区间(RIs)迫在眉睫,而将其从一种流式细胞仪系统转移到另一种流式细胞仪系统则是一种更可行、更方便的方法。本研究旨在探索不同流式细胞仪平台淋巴细胞亚群参考区间的可转移性:我们首先在四种 FCM 平台(包括 NovoCyte、BriCyteE6、DxFLEX 和 FACSCantoII 系统)上进行了方法配对比较。接着,我们评估了淋巴细胞亚群 RIs 的可转移性。此外,除 NK 细胞外,我们还基于 FACSCantoII 系统、BriCyteE6 系统和 DxFLEX 系统进行了 RIs 转移。通过计算已建立的RIs之间的偏差(CV),进一步验证了转移的RIs:结果:基于 NovoCyte、BriCyteE6、DxFLEX 和 FACSCantoII 系统的淋巴细胞亚群检测结果具有可比性,转移四种 FCM 系统检测到的淋巴细胞亚群的 RIs 是可行的。利用 FACSCantoII、DxFLEX 和 BriCyteE6 系统检测淋巴细胞亚群的 RIs 已经确定。将 FACSCantoII 系统的淋巴细胞亚群检测 RI 转移到 BriCyteE6 系统和 DxFLEX 系统后,除 NK 细胞外,所有参数的转移 RI 与建立的 RI 之间的 CV 值均低于 20%:本研究表明,除 NK 细胞外,淋巴细胞亚群的 RIs 可通过不同的定义策略在不同的流式细胞仪系统间转移。
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引用次数: 0
How do experts determine where to intervene on test ordering? An interview study. 专家如何确定对考试排序进行干预?一项访谈研究。
IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-23 DOI: 10.1515/cclm-2024-0948
Eyal Podolsky, Natasha Hudek, Nicola McCleary, Christopher McCudden, Justin Presseau, Jamie C Brehaut

Objectives: Lab testing is a high-volume activity that is often overused, leading to wasted resources and inappropriate care. Improving test ordering practices in tertiary care involves deciding where to focus scarce intervention resources, but clear guidance on how to optimize these resources is lacking. We aimed to explore context-sensitive factors and processes that inform individual decisions about laboratory stewardship interventions by speaking to key interest holders in this area.

Methods: We conducted semi-structured interviews with test-ordering intervention development experts and authors of test-ordering guidance documents to explore five broad topics: 1) processes used to prioritize tests for intervention; 2) factors considered when deciding which tests to target; 3) measurement of these factors; 4) interventions selected; 5) suggestions for a framework to support these decisions. Transcripts were double coded using directed-content and thematic analysis.

Results: We interviewed 14 intervention development experts. Experts noted they frequently consider test volume, test value, and patient care when deciding on a test to target. Experts indicated that quantifying many relevant factors was challenging. Processes to support these decisions often involved examining local data, obtaining buy-in, and relying on an existing guideline. Suggestions for building a framework emphasized the importance of collaboration, consideration of context and resources, and starting with "easy wins" to gain support and experience.

Conclusions: Our study provides insight into the factors and processes experts consider when deciding which tests to target for intervention and can inform the development of a framework to guide the selection of tests for intervention and guideline development.

目标:实验室检验是一项工作量很大的工作,但经常被过度使用,导致资源浪费和不当护理。改善三级医疗机构的检验订购实践需要决定将稀缺的干预资源集中在哪里,但目前还缺乏关于如何优化这些资源的明确指导。我们的目的是通过与这一领域的主要利益相关者交谈,探索个人决定实验室监管干预措施的背景敏感因素和过程:我们对试验排序干预措施开发专家和试验排序指导文件的作者进行了半结构化访谈,探讨了五大主题:1) 确定干预测试优先次序的过程;2) 决定针对哪些测试时考虑的因素;3) 对这些因素的衡量;4) 选择的干预措施;5) 对支持这些决定的框架的建议。采用定向内容和主题分析法对记录誊本进行双重编码:我们采访了 14 位干预措施开发专家。专家们指出,在决定测试目标时,他们经常会考虑测试量、测试价值和患者护理。专家们表示,量化许多相关因素具有挑战性。支持这些决策的程序通常包括检查当地数据、获得支持以及依赖现有指南。关于建立框架的建议强调了合作、考虑背景和资源的重要性,以及从 "易胜 "开始以获得支持和经验的重要性:我们的研究深入探讨了专家们在决定针对哪些检验进行干预时所考虑的因素和过程,并可为制定框架提供参考,从而指导检验干预的选择和指南的制定。
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引用次数: 0
期刊
Clinical chemistry and laboratory medicine
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