scholarly journals Combined strategy of knowledge‐based rule selection and historical data percentile‐based range determination to improve an autoverification system for clinical chemistry test results

Author(s):  
Jing Zhu ◽  
Hao Wang ◽  
Beili Wang ◽  
Xiaoke Hao ◽  
Wei Cui ◽  
...  
Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1019
Author(s):  
Kyungjin Hong ◽  
Gabriella Iacovetti ◽  
Ali Rahimian ◽  
Sean Hong ◽  
Jon Epperson ◽  
...  

Blood sample collection and rapid separation—critical preanalytical steps in clinical chemistry—can be challenging in decentralized collection settings. To address this gap, the Torq™ zero delay centrifuge system includes a lightweight, hand-portable centrifuge (ZDrive™) and a disc-shaped blood collection device (ZDisc™) enabling immediate sample centrifugation at the point of collection. Here, we report results from clinical validation studies comparing performance of the Torq System with a conventional plasma separation tube (PST). Blood specimens from 134 subjects were collected and processed across three independent sites to compare ZDisc and PST performance in the assessment of 14 analytes (K, Na, Cl, Ca, BUN, creatinine, AST, ALT, ALP, total bilirubin, albumin, total protein, cholesterol, and triglycerides). A 31-subject precision study was performed to evaluate reproducibility of plasma test results from ZDiscs, and plasma quality was assessed by measuring hemolysis and blood cells from 10 subject specimens. The ZDisc successfully collected and processed samples from 134 subjects. ZDisc results agreed with reference PSTs for all 14 analytes with mean % biases well below clinically significant levels. Results were reproducible across different operators and ZDisc production lots, and plasma blood cell counts and hemolysis levels fell well below clinical acceptance thresholds. ZDiscs produce plasma samples equivalent to reference PSTs. Results support the suitability of the Torq System for remotely collecting and processing blood samples in decentralized settings.


2020 ◽  
Vol 32 (3) ◽  
pp. 394-400
Author(s):  
Giovani Trevisan ◽  
Leticia C. M. Linhares ◽  
Bret Crim ◽  
Poonam Dubey ◽  
Kent J. Schwartz ◽  
...  

We developed a model to predict the cyclic pattern of porcine reproductive and respiratory syndrome virus (PRRSV) RNA detection by reverse-transcription real-time PCR (RT-rtPCR) from 4 major swine-centric veterinary diagnostic laboratories (VDLs) in the United States and to use historical data to forecast the upcoming year’s weekly percentage of positive submissions and issue outbreak signals when the pattern of detection was not as expected. Standardized submission data and test results were used. Historical data (2015–2017) composed of the weekly percentage of PCR-positive submissions were used to fit a cyclic robust regression model. The findings were used to forecast the expected weekly percentage of PCR-positive submissions, with a 95% confidence interval (CI), for 2018. During 2018, the proportion of PRRSV-positive submissions crossed 95% CI boundaries at week 2, 14–25, and 48. The relatively higher detection on week 2 and 48 were mostly from submissions containing samples from wean-to-market pigs, and for week 14–25 originated mostly from samples from adult/sow farms. There was a recurring yearly pattern of detection, wherein an increased proportion of PRRSV RNA detection in submissions originating from wean-to-finish farms was followed by increased detection in samples from adult/sow farms. Results from the model described herein confirm the seasonal cyclic pattern of PRRSV detection using test results consolidated from 4 VDLs. Wave crests occurred consistently during winter, and wave troughs occurred consistently during the summer months. Our model was able to correctly identify statistically significant outbreak signals in PRRSV RNA detection at 3 instances during 2018.


2018 ◽  
Vol 65 (1) ◽  
pp. 95-115
Author(s):  
Hami Saka ◽  
Mehmet Orhan

This study is an attempt to compare and contrast the credit ratings granted by prominent agencies, the so-called Big Three namely S&P, Moody?s and Fitch, that dominate the market. The sovereign ratings are proven to motivate the CDS figures of countries empirically, and low ratings are known to increase the interest paid to liabilities by these countries. We employ the historical data over 1994-2014 on the sovereign ratings of 117 countries to test for whether the ratings assigned by CRAs are significantly different or not, with the help of paired-t and ANOVA tests. Hypothesis test results reveal that such differences are significant for many countries and country groups, suggesting that the ratings by CRAs are not consistent with each other. This is true for BRIC, OECD, and emerging market countries. Extra ANOVA tests that we conducted support our findings.


2020 ◽  
Author(s):  
Abdurrahman Coşkun ◽  
Sverre Sandberg ◽  
Ibrahim Unsal ◽  
Coskun Cavusoglu ◽  
Mustafa Serteser ◽  
...  

Abstract Background The concept of personalized medicine has received widespread attention in the last decade. However, personalized medicine depends on correct diagnosis and monitoring of patients, for which personalized reference intervals for laboratory tests may be beneficial. In this study, we propose a simple model to generate personalized reference intervals based on historical, previously analyzed results, and data on analytical and within-subject biological variation. Methods A model using estimates of analytical and within-subject biological variation and previous test results was developed. We modeled the effect of adding an increasing number of measurement results on the estimation of the personal reference interval. We then used laboratory test results from 784 adult patients (>18 years) considered to be in a steady-state condition to calculate personalized reference intervals for 27 commonly requested clinical chemistry and hematology measurands. Results Increasing the number of measurements had little impact on the total variation around the true homeostatic set point and using ≥3 previous measurement results delivered robust personalized reference intervals. The personalized reference intervals of the study participants were different from one another and, as expected, located within the common reference interval. However, in general they made up only a small proportion of the population-based reference interval. Conclusions Our study shows that, if using results from patients in steady state, only a few previous test results and reliable estimates of within-subject biological variation are required to calculate personalized reference intervals. This may be highly valuable for diagnosing patients as well as for follow-up and treatment.


1979 ◽  
Vol 25 (6) ◽  
pp. 870-872 ◽  
Author(s):  
P P Sher

Abstract We developed of computer programs to evaluate the clinical reliability of test results by comparing each new result with previous results for the same patient, and to signal discrepancies in real time. These "delta check" discrepancies are noted, and they must be reviewed by the laboratory staff before results can appear on a patient's record. During a month, I reviewed 1403 such delta check messages and detected 55 (3.9%) that could not be explained on the basis of the patient's clinical condition. Of these, 23 represented true laboratory errors, which were corrected. The recognition of discrepancies before they appear on patients' reports has facilitated the operation of the clinical chemistry laboratory. Mislabeled and otherwise mishandled specimens are discovered before erroneous results appear on a patient's record.


2019 ◽  
Vol 29 (2) ◽  
pp. 334-345 ◽  
Author(s):  
Janne Cadamuro ◽  
Michael Cornes ◽  
Ana-Maria Simundic ◽  
Barbara de la Salle ◽  
Gunn B.B. Kristensen ◽  
...  

Introduction: No guideline currently exists on how to detect or document haemolysis, icterus or lipemia (HIL) in blood samples, nor on subsequent use of this information. The EFLM WG-PRE has performed a survey for assessing current practices of European laboratories in HIL monitoring. This second part of two coherent articles is focused on HIL. Materials and methods: An online survey, containing 39 questions on preanalytical issues, was disseminated among EFLM member countries. Seventeen questions exclusively focused on assessment, management and follow-up actions of HIL in routine blood samples. Results: Overall, 1405 valid responses from 37 countries were received. A total of 1160 (86%) of all responders stating to analyse blood samples - monitored HIL. HIL was mostly checked in clinical chemistry samples and less frequently in those received for coagulation, therapeutic drug monitoring and serology/infectious disease testing. HIL detection by automatic HIL indices or visual inspection, along with haemolysis cut-offs definition, varied widely among responders. A quarter of responders performing automated HIL checks used internal quality controls. In haemolytic/icteric/lipemic samples, most responders (70%) only rejected HIL-sensitive parameters, whilst about 20% released all test results with general comments. Other responders did not analysed but rejected the entire sample, while some released all tests, without comments. Overall, 26% responders who monitored HIL were using this information for monitoring phlebotomy or sample transport quality. Conclusion: Strategies for monitoring and treating haemolytic, icteric or lipemic samples are quite heterogeneous in Europe. The WG-PRE will use these insights for developing and providing recommendations aimed at harmonizing strategies across Europe.


1990 ◽  
Vol 24 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Barbara L. Leard ◽  
Richard D. Alsaker ◽  
William P. Porter ◽  
LaDean P. Sobel

Haemolysis has been known to cause artefacts in certain canine serum chemistry parameters. These parameters are often used by researchers to detect toxicity in certain studies; haemolysis, therefore, can make serum chemistry interpretation very difficult. In order to determine whether a relationship existed between the level of haemolysis and certain canine serum chemistry parameters, haemolysis was artificially induced by adding a haemolysate of known haemoglobin concentration to serum specimens. A routine clinical chemistry profile was performed on each specimen. Statistical analyses were performed on the results to examine the relationship between level of haemolysis and serum chemistry results. Interpretation of serum chemistry results of haemolysed canine sera paralleled, in most cases, human historical data.


10.12737/5738 ◽  
2014 ◽  
Vol 2 (5) ◽  
pp. 29-33
Author(s):  
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Elena Kolyman ◽  
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Evgeniy Rapotsevich

This paper considers theconcept of qualityeducationand modern ways ofitsdiagnosis,such asthe Unified State Examination (GPA) and the FederalInternet- based Exam in vocational education. The dynamics of the GPA on mathematics in Russia and Novosibirsk Region during last two years are analyzedin order to estimate the effectiveness of using GPA as a knowledge quality indicator.The paper delivers results of assessment of residual school mathematical knowledge based on the entrance test results among incoming first-year students (specialties: Public and Municipal Administration, Human Resource Management) of Siberian Branch of the Russian Presidential Academy of National Economy and Public Administration (Siberian Branch of RANEPA). Empirical material of the main sections of school Mathematics is provided and the correlation between the entrance test results and the results of the Unified State Examination is assessed. The conclusion is drawn that the results of the Unified State Examination arenot objective indicators of the incoming first-year students� knowledge of Maths. It is shownthat the FederalInternet-based Examin vocational educationhasa number of disadvantages, removal of whichwill affect itsobjectivity. The authors discussandanalyze the results ofthe FederalInternet-based Exam on Mathematics of studentsof Siberian Branch of the Russian Presidential Academy of National Economy and Public Administration (Siberian Branch of RANEPA). The hypothesis regarding possible reasons of current situation is put forward and steps to be taken for improving student assimilation of Mathematics and Natural Science of Bachelor�s Degree programs are described.


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