Pub Date : 2025-10-15DOI: 10.1093/clinchem/hvaf123
Raymond Nistor-Gallo, Kurt Zatloukal, Karin Schwenoha
The European Union (EU) In Vitro Diagnostic Regulation (IVDR) imposes stringent obligations on laboratories using in-house in vitro diagnostic devices (IH-IVDs), yet offers limited clarity on whether discrete work flow steps may be subcontracted while maintaining compliance with Article 5(5). This Special Report identifies 3 systemic challenges that amplify regulatory uncertainty: (a) fragmented national implementation of the IVDR, (b) disparities in the application of ISO 15189-based quality systems, and (c) the withdrawal of Conformité Européene (CE)-marked IVDs from the market, often replaced by research use only (RUO) products that shift the regulatory burden to public laboratories. These dynamics disproportionately affect diagnostics for rare diseases, emerging pathogens, and precision medicine, areas where commercial IVDs are often unavailable or withdrawn for cost reasons. Laboratories are increasingly compelled to adopt RUO products within IH-IVD work flows, accepting legal and clinical responsibility for analytical validity without clear regulatory protection. At the same time, innovation in academic and translational settings is hindered by uneven national oversight, premature enforcement of deferred IVDR clauses, and the absence of a harmonized European compliance model. We analyze these pressures through the lens of the respective Medical Device Coordination Group (MDCG) guidance, current national practices, and ISO 5649:2024—a newly published standard offering risk-based governance of IH-IVDs. ISO 5649 enables safe subcontracting under strict accountability and provides a structured compliance pathway aligned with the IVDR. Without urgent coordination across Member States and adoption of such frameworks, the EU risks undermining both patient access and diagnostic innovation under the banner of regulatory harmonization.
{"title":"Regulatory Fragmentation in Europe and Its Risks for Patient Access and Safety: Subcontracting Work Flow Steps of In-House Diagnostic Procedures","authors":"Raymond Nistor-Gallo, Kurt Zatloukal, Karin Schwenoha","doi":"10.1093/clinchem/hvaf123","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf123","url":null,"abstract":"The European Union (EU) In Vitro Diagnostic Regulation (IVDR) imposes stringent obligations on laboratories using in-house in vitro diagnostic devices (IH-IVDs), yet offers limited clarity on whether discrete work flow steps may be subcontracted while maintaining compliance with Article 5(5). This Special Report identifies 3 systemic challenges that amplify regulatory uncertainty: (a) fragmented national implementation of the IVDR, (b) disparities in the application of ISO 15189-based quality systems, and (c) the withdrawal of Conformité Européene (CE)-marked IVDs from the market, often replaced by research use only (RUO) products that shift the regulatory burden to public laboratories. These dynamics disproportionately affect diagnostics for rare diseases, emerging pathogens, and precision medicine, areas where commercial IVDs are often unavailable or withdrawn for cost reasons. Laboratories are increasingly compelled to adopt RUO products within IH-IVD work flows, accepting legal and clinical responsibility for analytical validity without clear regulatory protection. At the same time, innovation in academic and translational settings is hindered by uneven national oversight, premature enforcement of deferred IVDR clauses, and the absence of a harmonized European compliance model. We analyze these pressures through the lens of the respective Medical Device Coordination Group (MDCG) guidance, current national practices, and ISO 5649:2024—a newly published standard offering risk-based governance of IH-IVDs. ISO 5649 enables safe subcontracting under strict accountability and provides a structured compliance pathway aligned with the IVDR. Without urgent coordination across Member States and adoption of such frameworks, the EU risks undermining both patient access and diagnostic innovation under the banner of regulatory harmonization.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"1 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295854","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}
Pub Date : 2025-10-15DOI: 10.1093/clinchem/hvaf116
Nasir Saeed, Ingar Z Restan, Ole-Thomas Steiro, Hilde L Tjora, Jørund Langørgen, Øyvind Skadberg, Øistein R Mjelva, Vernon V S Bonarjee, Rune O Bjørneklett, Trude Steinsvik, Kjell Vikenes, Torbjørn Omland, Fred S Apple, Allan S Jaffe, Nicholas L Mills, Paul O Collinson, Peter A Kavsak, Kristin M Aakre
Background This study simulates how assay-specific bias influences the diagnostic performance of 0/1-h accelerated diagnostic protocols (ADPs) for 3 different high-sensitivity cardiac troponin (hs-cTn) assays. Methods We included 1493 patients presenting with chest pain. hs-cTnT (Roche Diagnostics), hs-cTnI from Abbott Diagnostics (hs-cTnI-A), and Siemens Healthineers (hs-cTnI-S) were measured at admission. The absolute total error observed in a state-of-the-art EQA study were added to the admission concentrations, producing 6 new variables being adjusted for maximum possible bias (if analytical variation is 0) (+biasmean, +biasmax95%CI, +biasmin95%CI, −biasmean, −biasmax95%CI, −biasmin95%CI). The influence of this “worst-case scenario” bias was compared after calculating sensitivity, specificity, negative and positive predictive values, and rule-out proportion for 30-day myocardial infarction or death for the observed and bias-adjusted hs-cTn concentrations. Results For 0-h rule-out, hs-cTnI-S and hs-cTnT had a sensitivity of >99.0%, compared to 97.7% for hs-cTnI-A. After adding the bias, sensitivity was unchanged for hs-cTnI-S (99.5%), but lower for hs-cTnT (95.5%), and hs-cTnI-A (96.2%). For the 0-/1-h algorithm, adding bias reduced sensitivity to 95.5% for hs-cTnT, while both hs-cTnI algorithms were unchanged (100.0%). Rule-out proportions for 0 h ranged from 0% to 60.0% for hs-cTnT, 28.2%–62.7% for hs-cTnI-A, and 3.5%–35.5% for hs-cTnI-S. For the 0-/1-h algorithm, ranges were 57.7%–75.8% (hs-cTnT), 52.8%–67.5% (hs-cTnI-A), and 45.7%–61.2% (hs-cTnI-S), Conclusion Analytical bias of hs-cTn assays affects the clinical rule-out rate of the 0/1-h ADPs more than the diagnostic sensitivity. Bias may have a greater influence on the proportion of patients requiring hospital admission and may contribute to the heterogeneity of the reported rule-out rates of current ADPs. ClinicalTrials.gov Registration Number: NCT02620202
{"title":"Analytical Error of Cardiac Troponin and Impact on the Performance of Accelerated Diagnostic Protocols in Patients with Acute Chest Pain","authors":"Nasir Saeed, Ingar Z Restan, Ole-Thomas Steiro, Hilde L Tjora, Jørund Langørgen, Øyvind Skadberg, Øistein R Mjelva, Vernon V S Bonarjee, Rune O Bjørneklett, Trude Steinsvik, Kjell Vikenes, Torbjørn Omland, Fred S Apple, Allan S Jaffe, Nicholas L Mills, Paul O Collinson, Peter A Kavsak, Kristin M Aakre","doi":"10.1093/clinchem/hvaf116","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf116","url":null,"abstract":"Background This study simulates how assay-specific bias influences the diagnostic performance of 0/1-h accelerated diagnostic protocols (ADPs) for 3 different high-sensitivity cardiac troponin (hs-cTn) assays. Methods We included 1493 patients presenting with chest pain. hs-cTnT (Roche Diagnostics), hs-cTnI from Abbott Diagnostics (hs-cTnI-A), and Siemens Healthineers (hs-cTnI-S) were measured at admission. The absolute total error observed in a state-of-the-art EQA study were added to the admission concentrations, producing 6 new variables being adjusted for maximum possible bias (if analytical variation is 0) (+biasmean, +biasmax95%CI, +biasmin95%CI, −biasmean, −biasmax95%CI, −biasmin95%CI). The influence of this “worst-case scenario” bias was compared after calculating sensitivity, specificity, negative and positive predictive values, and rule-out proportion for 30-day myocardial infarction or death for the observed and bias-adjusted hs-cTn concentrations. Results For 0-h rule-out, hs-cTnI-S and hs-cTnT had a sensitivity of >99.0%, compared to 97.7% for hs-cTnI-A. After adding the bias, sensitivity was unchanged for hs-cTnI-S (99.5%), but lower for hs-cTnT (95.5%), and hs-cTnI-A (96.2%). For the 0-/1-h algorithm, adding bias reduced sensitivity to 95.5% for hs-cTnT, while both hs-cTnI algorithms were unchanged (100.0%). Rule-out proportions for 0 h ranged from 0% to 60.0% for hs-cTnT, 28.2%–62.7% for hs-cTnI-A, and 3.5%–35.5% for hs-cTnI-S. For the 0-/1-h algorithm, ranges were 57.7%–75.8% (hs-cTnT), 52.8%–67.5% (hs-cTnI-A), and 45.7%–61.2% (hs-cTnI-S), Conclusion Analytical bias of hs-cTn assays affects the clinical rule-out rate of the 0/1-h ADPs more than the diagnostic sensitivity. Bias may have a greater influence on the proportion of patients requiring hospital admission and may contribute to the heterogeneity of the reported rule-out rates of current ADPs. ClinicalTrials.gov Registration Number: NCT02620202","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"5 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295801","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}
Pub Date : 2025-10-13DOI: 10.1093/clinchem/hvaf114
John C Mathers
BACKGROUNDThe past 2 decades have seen rapid advances in the development of the concept of personalized nutrition (PN) interventions, and in its application. PN has evolved from attempts to understand the well-recognized interindividual variability in response to dietary intervention that have been facilitated by developments in -omics technologies, systems thinking, and behavioral psychology. The PN concept is predicated on the idea that it is possible to collect, and to use, specific information about individuals, including clinical chemistry, as an evidence base for more effective dietary advice, products, or services.CONTENTThis paper provides a narrative review of recent developments in the design and testing of PN interventions, including use of clinical chemistry measurements. The term PN is used to include all approaches that employ specific information about individuals to tailor interventions that are designed to be more relevant to, and effective for, that individual. In addition, the paper considers the potential for PN approaches to contribute to better public health.SUMMARYThere is good evidence that PN interventions can improve eating behavior with potential to improve health but much remains to be done to make PN interventions more effective, to reduce the burden on participants, and to enable cost-effective and equitable scale-up before they can make a significant contribution to better public health.
{"title":"Harnessing Personalized Nutrition and Clinical Chemistry: Opportunities to Improve Public Health.","authors":"John C Mathers","doi":"10.1093/clinchem/hvaf114","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf114","url":null,"abstract":"BACKGROUNDThe past 2 decades have seen rapid advances in the development of the concept of personalized nutrition (PN) interventions, and in its application. PN has evolved from attempts to understand the well-recognized interindividual variability in response to dietary intervention that have been facilitated by developments in -omics technologies, systems thinking, and behavioral psychology. The PN concept is predicated on the idea that it is possible to collect, and to use, specific information about individuals, including clinical chemistry, as an evidence base for more effective dietary advice, products, or services.CONTENTThis paper provides a narrative review of recent developments in the design and testing of PN interventions, including use of clinical chemistry measurements. The term PN is used to include all approaches that employ specific information about individuals to tailor interventions that are designed to be more relevant to, and effective for, that individual. In addition, the paper considers the potential for PN approaches to contribute to better public health.SUMMARYThere is good evidence that PN interventions can improve eating behavior with potential to improve health but much remains to be done to make PN interventions more effective, to reduce the burden on participants, and to enable cost-effective and equitable scale-up before they can make a significant contribution to better public health.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"136 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277321","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}
Pub Date : 2025-10-10DOI: 10.1093/clinchem/hvaf110
Nora Fino,Lesley A Inker,Seiei Shiba,Ogechi M Adingwupu,Josef Coresh,Ben Haaland,Michael G Shlipak,Andrew Levey,Jesse C Seegmiller, ,
BACKGROUNDEstimated glomerular filtration rate (eGFR) using creatinine (eGFRcr), cystatin C (eGFRcys), or both (eGFRcr-cys) is not sufficiently accurate in many settings, often due to non-glomerular filtration rate (GFR) determinants of the filtration markers. In principle, using a panel of endogenous markers (panel eGFR) could reduce the impact of non-GFR determinants of each marker, improving the accuracy of eGFR. Using global untargeted metabolomics, we previously identified 33 endogenous metabolites that correlate highly with measured GFR.METHODSA LC-MS/MS measurement procedure was developed to quantify 11 endogenous metabolites from serum and plasma. The assay was evaluated in 99 participants with measured GFR (mGFR) from 2 research studies, including a subgroup of 51 participants with large errors in eGFRcr and large discordance between eGFRcr and eGFRcys. Performance of eGFR models using single metabolites and all metabolites (panel eGFR-11) compared to mGFR was assessed by leave-one-out cross-validated root mean square error (RMSE).RESULTSAssay CV for single metabolites ranged from 1.1% to 6.3% over the course of 21 days. RMSE of eGFR in single metabolite models ranged from 0.184 to 0.324. RMSEs for panel eGFR-11, eGFRcr, and eGFRcr-cys were 0.195, 0.251, and 0.201, respectively, and 0.155, 0.290, and 0.203, respectively, in the subgroup with large errors and large discordance.CONCLUSIONSA precise metabolite (LC-MS/MS) measurement procedure shows promise for more accurate GFR estimation when eGFRcr is unreliable, offering a potential new confirmatory test for GFR evaluation.
{"title":"Quantitative Analysis of a Novel Metabolite Panel to Estimate GFR (Panel eGFR) in Serum and Plasma Using LC-MS/MS.","authors":"Nora Fino,Lesley A Inker,Seiei Shiba,Ogechi M Adingwupu,Josef Coresh,Ben Haaland,Michael G Shlipak,Andrew Levey,Jesse C Seegmiller, , ","doi":"10.1093/clinchem/hvaf110","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf110","url":null,"abstract":"BACKGROUNDEstimated glomerular filtration rate (eGFR) using creatinine (eGFRcr), cystatin C (eGFRcys), or both (eGFRcr-cys) is not sufficiently accurate in many settings, often due to non-glomerular filtration rate (GFR) determinants of the filtration markers. In principle, using a panel of endogenous markers (panel eGFR) could reduce the impact of non-GFR determinants of each marker, improving the accuracy of eGFR. Using global untargeted metabolomics, we previously identified 33 endogenous metabolites that correlate highly with measured GFR.METHODSA LC-MS/MS measurement procedure was developed to quantify 11 endogenous metabolites from serum and plasma. The assay was evaluated in 99 participants with measured GFR (mGFR) from 2 research studies, including a subgroup of 51 participants with large errors in eGFRcr and large discordance between eGFRcr and eGFRcys. Performance of eGFR models using single metabolites and all metabolites (panel eGFR-11) compared to mGFR was assessed by leave-one-out cross-validated root mean square error (RMSE).RESULTSAssay CV for single metabolites ranged from 1.1% to 6.3% over the course of 21 days. RMSE of eGFR in single metabolite models ranged from 0.184 to 0.324. RMSEs for panel eGFR-11, eGFRcr, and eGFRcr-cys were 0.195, 0.251, and 0.201, respectively, and 0.155, 0.290, and 0.203, respectively, in the subgroup with large errors and large discordance.CONCLUSIONSA precise metabolite (LC-MS/MS) measurement procedure shows promise for more accurate GFR estimation when eGFRcr is unreliable, offering a potential new confirmatory test for GFR evaluation.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"37 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261506","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}
Pub Date : 2025-10-10DOI: 10.1093/clinchem/hvaf122
Anne Elisabeth Solsvik, Pernille Fauskanger, Anne Stavelin, Eva Rønneseth, Sverre Sandberg
Background External quality assessment (EQA) should strive to monitor and reflect variation across laboratories and measuring systems. We introduce a newly developed patient-based EQA program named Noklus Patient Median (NOPAM) that is freely available for the participants. The results from NOPAM enable laboratories to (a) compare their result to their peer group, (b) assess equivalence between measurement procedures, and (c) monitor the long-term median value within a laboratory. Methods Daily instrument-specific medians and percentages of patient results outside reference limits for the measurand in question are sent from laboratories to the program. For a particular grouping within a specific time frame, the program estimates distribution statistics of center and dispersion. Results In total, 40 common measurands are included in NOPAM. The 1-year results for selected measurands (alanine aminotransferase, chloride, creatinine, and free thyroxine) for the largest instrument groups are presented. An example of an upward shift for alkaline phosphatase (ALP) for 3 instruments within one laboratory is presented. This shift is notable both for the daily median and the percentage of results above the upper reference limit. However, a corresponding bias is not reflected in the instrument group for ALP. Conclusions A patient-based dynamic EQA program offers several advantages over traditional EQA programs. Among the most significant benefits are the frequent performance monitoring and the elimination of the commutability problems. Our results show that there are important differences between frequently used measurement procedures. NOPAM can be used to monitor standardization and harmonization efforts.
{"title":"A New International Patient-Based External Quality Assessment Program to Monitor Harmonization and Standardization Efforts","authors":"Anne Elisabeth Solsvik, Pernille Fauskanger, Anne Stavelin, Eva Rønneseth, Sverre Sandberg","doi":"10.1093/clinchem/hvaf122","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf122","url":null,"abstract":"Background External quality assessment (EQA) should strive to monitor and reflect variation across laboratories and measuring systems. We introduce a newly developed patient-based EQA program named Noklus Patient Median (NOPAM) that is freely available for the participants. The results from NOPAM enable laboratories to (a) compare their result to their peer group, (b) assess equivalence between measurement procedures, and (c) monitor the long-term median value within a laboratory. Methods Daily instrument-specific medians and percentages of patient results outside reference limits for the measurand in question are sent from laboratories to the program. For a particular grouping within a specific time frame, the program estimates distribution statistics of center and dispersion. Results In total, 40 common measurands are included in NOPAM. The 1-year results for selected measurands (alanine aminotransferase, chloride, creatinine, and free thyroxine) for the largest instrument groups are presented. An example of an upward shift for alkaline phosphatase (ALP) for 3 instruments within one laboratory is presented. This shift is notable both for the daily median and the percentage of results above the upper reference limit. However, a corresponding bias is not reflected in the instrument group for ALP. Conclusions A patient-based dynamic EQA program offers several advantages over traditional EQA programs. Among the most significant benefits are the frequent performance monitoring and the elimination of the commutability problems. Our results show that there are important differences between frequently used measurement procedures. NOPAM can be used to monitor standardization and harmonization efforts.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"102 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260661","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}
Pub Date : 2025-10-03DOI: 10.1093/clinchem/hvaf089
Nicholas E Larkey,Mark R Girton
{"title":"Risk vs Prevalence: Weighing Routine DYPD Variant Testing Prior to Fluoropyrimidine-Based Chemotherapy.","authors":"Nicholas E Larkey,Mark R Girton","doi":"10.1093/clinchem/hvaf089","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf089","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"98 1","pages":"1097-1098"},"PeriodicalIF":9.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209156","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}
Pub Date : 2025-10-03DOI: 10.1093/clinchem/hvaf031
Edward J Filippone, Walter K Kraft
{"title":"Optimizing Estimation: Perspective on Drug Dosing Using New CKD-EPI Equations.","authors":"Edward J Filippone, Walter K Kraft","doi":"10.1093/clinchem/hvaf031","DOIUrl":"10.1093/clinchem/hvaf031","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":" ","pages":"1014-1017"},"PeriodicalIF":6.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741818","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}
Pub Date : 2025-10-03DOI: 10.1093/clinchem/hvaf062
Maxwell L Harsha,Mark A Marzinke
{"title":"Supratherapeutic Carbamazepine Concentration Following a Recent SARS-CoV-2 Infection.","authors":"Maxwell L Harsha,Mark A Marzinke","doi":"10.1093/clinchem/hvaf062","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf062","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"76 1","pages":"1018-1022"},"PeriodicalIF":9.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209157","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}
Pub Date : 2025-10-03DOI: 10.1093/clinchem/hvaf091
Sarah R Delaney
{"title":"Commentary on Supratherapeutic Carbamazepine Concentration Following a Recent SARS-CoV-2 Infection.","authors":"Sarah R Delaney","doi":"10.1093/clinchem/hvaf091","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf091","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"99 1","pages":"1023"},"PeriodicalIF":9.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209158","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}
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