scholarly journals Point-of-care high-sensitivity assay on PATHFAST as the backup in the emergency room

2021 ◽  
Vol 5 ◽  
pp. 239920262110550
Author(s):  
Joško Osredkar ◽  
Katja Krivic ◽  
Teja Fabjan ◽  
Kristina Kumer ◽  
Jure Tršan ◽  
...  
Keyword(s):  
Blood Serum ◽  
Troponin I ◽  
Point Of Care ◽  
High Sensitivity ◽  
Turnaround Time ◽  
Serum Samples ◽  
Linear Relationships ◽  
Accuracy And Precision ◽  
Laboratory Results ◽  
Key Indicators

Aim: Although the levels of cardiac troponin I (cTnI) have proved to be a useful diagnostic biomarker of acute myocardial infarction, there are a wide variety of point-of-care (POC) analysers, which provide measurements of cTnI. The aim of this study was to compare the results obtained by the ADVIA Centaur ultra-assay cTnI assay (us-cTnI), ADVIA Centaur high-sensitive cTnI assay (hs-cTnI) and a POC high-sensitivity assay using PATHFAST. We also aimed to explore total turnaround time (TAT) for laboratory results using the POC PATHFAST analyser. Methods: Samples from 161 patients were taken. Of these samples, 129 were tested with all three assays (us-cTnI, hs-cTnI and PATHFAST), and 32 samples were tested on PATHFAST for the comparison of whole blood, serum and plasma. Results: Comparison of the POC testing methods in this study demonstrated that there are strong linear relationships between all three cTnI assays (us-cTnI, hs-cTnI and POC on PATHFAST). Furthermore, we also show there are strong linear relationships between the two high-sensitive cTnI assays (hs-cTnI and PATHFAST) for blood serum samples, as determined by Passing–Bablok regression analyses. In our comparison of our new data with our older study, the TAT went down. Conclusion: The timeliness of laboratory results is, in addition to accuracy and precision, one of the key indicators of laboratory performance, and at the same time has a significant impact on the course of the patient’s condition. It is therefore important that the laboratory strives to meet the expectations of clinicians regarding the time from the order to the result of the analysis.

scholarly journals A rapid point-of-care assay accurately measures vitamin D

2021 ◽  
Author(s):  
K. Albrecht ◽  
J. Lotz ◽  
L. Frommer ◽  
K. J. Lackner ◽  
G. J. Kahaly
Keyword(s):  
Vitamin D ◽  
Metabolic Pathways ◽  
Point Of Care ◽  
Immunofluorescence Assay ◽  
Laboratory Method ◽  
Controlled Study ◽  
Mean Deviation ◽  
Serum Samples ◽  
Assay Validation ◽  
Accuracy And Precision

Abstract Purpose Vitamin D (VitD) is a pleiotropic hormone with effects on a multitude of systems and metabolic pathways. Consequently, the relevance of a sufficiently high VitD serum level becomes self-evident. Methods A rapid immunofluorescence assay designed for the point-of-care measurement of serum VitD3 solely was tested. Inter- and intra-assay validation, double testing and result comparison with a standardized laboratory method were performed. Results An overall linear correlation of r = 0.89 (Pearson, 95% CI 0.88–0.92, p < 0.01) between the point of care and the conventional reference assay was registered. Accuracy and precision were of special interest at cut-points (10 ng/ml [mean deviation 1.7 ng/ml, SD 1.98 ng/ml, SE 0.16 ng/ml], 12 ng/ml [MD 0.41, SD 1.89, SE 0.19] and 30 ng/ml [MD − 1.11, SD 3.89, SE 0.35]). Only a slight deviation was detected between the two assays when using fresh (r = 0.91, 95% CI 0.86–0.94, p < 0.01) and frozen serum samples (r = 0.86, 0.82–0.89, p < 0.01). Results remained steady when samples were frozen several times. Inter- and intra-assay validation according to the CLSI protocol as well as multiuser testing showed stable results. Conclusion This novel, innovative, and controlled study indicates that the evaluated rapid point of care VitD assay is reliable, accurate, and suited for clinical practice.

Evaluation of two point of care technologies for measuring monoclonal antibody therapeutic-A concentrations in blood

Bioanalysis ◽  
2020 ◽  
Vol 12 (20) ◽  
pp. 1449-1458
Author(s):  
Saloumeh K Fischer ◽  
Kathi Williams ◽  
Ian Harmon ◽  
Bryan Bothwell ◽  
Hua Xu ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Real Time ◽  
Point Of Care ◽  
Turnaround Time ◽  
Monitoring Methods ◽  
Sample Collection ◽  
Time Data ◽  
Serum Samples ◽  
Quick Turnaround Time

Aim: Current blood monitoring methods require sample collection and testing at a central lab, which can take days. Point of care (POC) devices with quick turnaround time can provide an alternative with faster results, allowing for real-time data leading to better treatment decisions for patients. Results/Methodology: An assay to measure monoclonal antibody therapeutic-A was developed on two POC devices. Data generated using 75 serum samples (65 clinical & ten spiked samples) show correlative results to the data generated using Gyrolab technology. Conclusion: This case study uses a monoclonal antibody therapeutic-A concentration assay as an example to demonstrate the potential of POC technologies as a viable alternative to central lab testing with quick results allowing for real-time decision-making.

scholarly journals Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I

2020 ◽  
Vol 75 (10) ◽  
pp. 1111-1124 ◽  
Author(s):  
Jasper Boeddinghaus ◽  
Thomas Nestelberger ◽  
Luca Koechlin ◽  
Desiree Wussler ◽  
Pedro Lopez-Ayala ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Early Diagnosis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Point Of Care ◽  
High Sensitivity ◽  
Cardiac Troponin I

A rapid, sensitive enzyme-linked immunoassay for human thyrotropin.

1985 ◽  
Vol 31 (7) ◽  
pp. 1131-1134 ◽  
Author(s):  
Y C Tseng ◽  
K D Burman ◽  
J R Baker ◽  
L Wartofsky
Keyword(s):  
Color Change ◽  
Clinical Laboratory ◽  
High Sensitivity ◽  
Normal Subjects ◽  
Turnaround Time ◽  
Cross Reactivity ◽  
Serum Samples ◽  
Assay Sensitivity ◽  
Nitrophenyl Phosphate ◽  
Set Up

Abstract In this enzyme-linked immunoassay for human thyrotropin (TSH) in unextracted serum we use 96-well immunoenzymometric assay plates, first coated with polyclonal antibody to TSH, then incubated with the serum samples and reacted with mouse monoclonal antibody to human TSH. After incubation with alkaline phosphatase-labeled antibody against mouse IgG, disodium p-nitrophenyl phosphate is added and the color change is measured spectrophotometrically. Assay sensitivity is 0.1 milli-int. unit/L. Cross reactivity with lutropin, follitropin, or choriogonadotropin was negligible. TSH concentrations ranged from 0.4 to 4.1 milli-int. units/L in 43 normal subjects (mean 2.0, SD 1.0), and were uniformly less than 0.3 milli-int. unit/L in 23 patients with hyperthyroidism. Features which make this assay advantageous to the clinical laboratory include ease of set-up, ability to assay many samples at a time, high sensitivity, rapid turnaround time (8 h), and absence of requirements for radioactive materials.

scholarly journals Analytical Concordance of Diverse Point-of-Care and Central Laboratory Troponin I Assays

2019 ◽  
Vol 3 (5) ◽  
pp. 764-774 ◽  
Author(s):  
Albert K Y Tsui ◽  
Martha E Lyon ◽  
Sean van Diepen ◽  
Bobbi Lynn Goudreau ◽  
Dylan Thomas ◽  
...  
Keyword(s):  
Troponin I ◽  
Coronary Care Unit ◽  
Point Of Care ◽  
High Sensitivity ◽  
Clinical Decision ◽  
Central Laboratory ◽  
Excellent Correlation ◽  
Fresh Blood ◽  
Coronary Care ◽  
Abbott Architect

Abstract Background Cardiac troponin I (cTnI) 99th percentile cutoffs, used in the diagnosis of acute myocardial infarction, are not standardized across cTnI assays. We compared 3 point-of-care (POC) and 1 central laboratory contemporary cTnI assays against the Abbott high-sensitivity (hs) cTnI to evaluate the analytical concordance and the feasibility of using a single cutoff value for all assays. Methods Fresh blood samples collected from 102 inpatients in the coronary care unit were measured on central laboratory instruments (Beckman Coulter DxI AccuTnI+3 TnI, Abbott Architect hs-TnI) and cTnI POC analyzers (Alere Triage Troponin I, Radiometer AQT90, Abbott i-STAT). Agreement and correlation between the contemporary cTnI assays and hs-cTnI assay were assessed using regression analysis. Proportional bias was assessed using Bland–Altman plots. Concordance between the contemporary cTnI and hs-cTnI assays was determined by diagnostic contingency tables at specific cutoffs. Results Most POC cTnI assays had excellent correlation with the Abbott hs-cTnI method (r2 = 0.955–0.970) except for Alere Triage (r2 = 0.617), while proportional bias is evident between all cTnI assays. Overall concordance between POC contemporary cTnI assays and hs-cTnI assay was 80% to 90% at their respective 99th percentile cutoffs. The concordance increased to 90% to 95% when a fixed cutoff of 0.03 to 0.05 ng/mL was used across the assays. Conclusions This study demonstrates poor analytical concordance between cTnI assays at the 99th percentile and supports the notion of a single clinical decision limit for cTnI and consequently standardization of diagnostic protocols despite the analytical differences among these assays.

Evaluation of analytical performance of a new high-sensitivity immunoassay for cardiac troponin I

2018 ◽  
Vol 56 (3) ◽  
pp. 492-501 ◽  
Author(s):  
Silvia Masotti ◽  
Concetta Prontera ◽  
Veronica Musetti ◽  
Simona Storti ◽  
Rudina Ndreu ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
High Sensitivity ◽  
Cardiac Troponin I ◽  
Analytical Performance ◽  
Analytical Sensitivity ◽  
Plasma Samples ◽  
Serum Samples ◽  
Significant Difference ◽  
Heparin Plasma

AbstractBackground:The study aim was to evaluate and compare the analytical performance of the new chemiluminescent immunoassay for cardiac troponin I (cTnI), called Access hs-TnI using DxI platform, with those of Access AccuTnI+3 method, and high-sensitivity (hs) cTnI method for ARCHITECT platform.Methods:The limits of blank (LoB), detection (LoD) and quantitation (LoQ) at 10% and 20% CV were evaluated according to international standardized protocols. For the evaluation of analytical performance and comparison of cTnI results, both heparinized plasma samples, collected from healthy subjects and patients with cardiac diseases, and quality control samples distributed in external quality assessment programs were used.Results:LoB, LoD and LoQ at 20% and 10% CV values of the Access hs-cTnI method were 0.6, 1.3, 2.1 and 5.3 ng/L, respectively. Access hs-cTnI method showed analytical performance significantly better than that of Access AccuTnI+3 method and similar results to those of hs ARCHITECT cTnI method. Moreover, the cTnI concentrations measured with Access hs-cTnI method showed close linear regressions with both Access AccuTnI+3 and ARCHITECT hs-cTnI methods, although there were systematic differences between these methods. There was no difference between cTnI values measured by Access hs-cTnI in heparinized plasma and serum samples, whereas there was a significant difference between cTnI values, respectively measured in EDTA and heparin plasma samples.Conclusions:Access hs-cTnI has analytical sensitivity parameters significantly improved compared to Access AccuTnI+3 method and is similar to those of the high-sensitivity method using ARCHITECT platform.

scholarly journals COMPARISON OF PERFORMANCE CHARACTERISTICS BETWEEN LATERAL FLOW, ELISAAND ELECTROCHEMILUMINESCENCE IMMUNOASSAYS FOR THE DETECTION OF SARS-COV-2 ANTIBODIES AMONG HEALTHCARE WORKERS

2021 ◽  
pp. 45-48
Author(s):  
Shincy M R ◽  
Vandana Govindan ◽  
Sudhakar H H ◽  
Padmapriya K ◽  
Venkatesha V T ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Care Pathway ◽  
Point Of Care ◽  
High Sensitivity ◽  
Central Research ◽  
Serum Samples ◽  
Igg Antibody ◽  
Human Igg ◽  
Serological Tests

Background: The detection of SARS-CoV-2 IgG is important to determine the course of COVID-19. Medical professionals and researchers have been urging the need for wide and rapid testing of citizens in order to plan measures that can contain the spread of the virus. Antibody tests play an important role throughout the patient care pathway and are vital for the management and surveillance of the virus. Although RTPCR is considered to be the gold standard, serological tests based on antibodies could be very helpful for on-time detection. We performed one to one assessment of electrochemiluminescence immunoassay, enzyme immunoassay (EIAs), and point-of-care lateral ow assay (POCTs) to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibody. Materials and Methods: 611 healthcare workers were recruited between November and December 2020 at Central Research Laboratory, KIMS. ® Collected serum samples were analysed using three commercially available assays: the Elecsys , Anti-SARS CoV-2 Human IgG ELISA, the Standard Q IgG/IgM combo assay following the manufacturer's protocol to measure the IgG titer of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results:The kits displayed a sensitivity of 91.8%, 79.5% ,61.2% and a specicity of 80.2%, 64.1% ,61.7% in order. Conclusion: ® Our results indicate a high sensitivity and specicity for the Elecsys assay compared to Anti-SARS CoV-2 Human IgG ELISA, the Standard Q IgG/IgM combo assays.

scholarly journals P216 Comparative Assessment C-reactive Protein Between a Point-of-Care Testing and Current Standard of Care (Immunonephelometric testing)

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S272-S273
Author(s):  
G Lorenzon ◽  
I Marsilio ◽  
D Maniero ◽  
A Rigo ◽  
B Barberio ◽  
...  
Keyword(s):  
Inflammatory Disease ◽  
Point Of Care ◽  
Standard Of Care ◽  
Turnaround Time ◽  
Blood Collection ◽  
Standard Laboratory ◽  
Point Of Care Testing ◽  
C Reactive Protein ◽  
Serum Samples ◽  
Reactive Protein

Abstract Background C-reactive protein (CRP) is widely used as a biomarker of inflammatory disease activity in hospitalized and non-hospitalized patients. In particular, CRP is commonly used in patients suspected to have an inflammatory bowel disease (IBD) or with a confirmed diagnosis of IBD diagnosis in order to drive the diagnostic approach, to monitor disease activity and to guide therapeutic adjustments. However, standard laboratory CRP testing (Immunonephelometric assays) present some drawbacks, including a turnaround time of 1–2 hours, and the need of specialized equipment, offices and laboratory personnel. Because of that, point-of care testing (POCT) was recently developed in order to provide results within 2 minutes from blood collection, enabling a rapid response to clinical condition. Aim To determine the degree of analytical correlation between a recently developed POCT (ProciseDx) using capillary whole blood and the comparative Immunonephelometric assay using serum samples. Methods From October to November 2020, consecutive patients hospitalized at Gastroenterology Unit, Padua University Hospital, aged &gt; 18 years and with clinical evidence of active inflammatory disease or infection, who underwent to a standard of care CRP test (Dimension Vista – Siemens Healthineers) were included in the study (range 2.9–340 g/L). Within 1 hour from blood collection, in each patient, CRP quantitation from capillary whole blood collected by finger stick was performed using the ProciseDx CRP assay, with reportable range between 3.6–100 g/L. A Deming regression test was used to identify the correlation between the two methods. Results Eighty-three patients were enrolled (62.5% males with mean age ± SD: 60±18). The most common indications for hospitalisation were liver disease (34.9%), pancreatic disturbance (27.7%) and suspicious or recurrence of IBD (16.7%). ProciseDx POCT with finger prick samples required a turnaround time of 2±0.2 minutes, whereas serum samples analyzed in clinical laboratory with the reference method required a turnaround time of about 180±15 minutes (p&lt;0.001). Overall, the correlation between the two tests was high (R squared of 0.899 (95% CI 0.916–0.968)). In particular, the correlation between the methods was even higher with CRP values between 0–100 g/L with R squared of 0.961 (95% CI 0.958–0.986). Conclusion The ProciseDx POCT allows a more rapid and comparable accuracy of CRP assessment in hospitalized patients as compared to the standard laboratory measurement. Moreover, the ProciseDx POCT does not require specialised personnel to be performed. The use of ProciseDx POCT may improve and accelerate the decision-making approach, further reducing the resources required for CRP assessment.

scholarly journals Deep Learning-Enabled Point-of-Care Sensing Using Multiplexed Paper-Based Sensors

2019 ◽  
Author(s):  
Zachary Ballard ◽  
Hyou-Arm Joung ◽  
Artem Goncharov ◽  
Jesse Liang ◽  
Karina Nugroho ◽  
...  
Keyword(s):  
Machine Learning ◽  
Deep Learning ◽  
Point Of Care ◽  
Low Cost ◽  
High Sensitivity ◽  
Cost Effective ◽  
Serum Samples ◽  
Cvd Risk ◽  
Medical Test ◽  
Sensing Membrane

ABSTRACTWe present a deep learning-based framework to design and quantify point-of-care sensors. As its proof-of-concept and use-case, we demonstrated a low-cost and rapid paper-based vertical flow assay (VFA) for high sensitivity C-Reactive Protein (hsCRP) testing, a common medical test used for quantifying the degree of inflammation in patients at risk of cardio-vascular disease (CVD). A machine learning-based sensor design framework was developed for two key tasks: (1) to determine an optimal configuration of immunoreaction spots and conditions, spatially-multiplexed on a paper-based sensing membrane, and (2) to accurately infer the target analyte concentration based on the signals of the optimal VFA configuration. Using a custom-designed mobile-phone based VFA reader, a clinical study was performed with 85 human serum samples to characterize the quantification accuracy around the clinically defined cutoffs for CVD risk stratification. Results from blindly-tested VFAs indicate a competitive coefficient of variation of 11.2% with a linearity of R2 = 0.95; in addition to the success in the high-sensitivity CRP range (i.e., 0-10 mg/L), our results further demonstrate a mitigation of the hook-effect at higher CRP concentrations due to the incorporation of antigen capture spots within the multiplexed sensing membrane of the VFA. This paper-based computational VFA that is powered by deep learning could expand access to CVD health screening, and the presented machine learning-enabled sensing framework can be broadly used to design cost-effective and mobile sensors for various point-of-care diagnostics applications.

Determination of sex-specific 99th percentile upper reference limits for a point of care high sensitivity cardiac troponin I assay

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fred S. Apple ◽  
Karen Schulz ◽  
Christian W. Schmidt ◽  
Trees S. Y. van Domburg ◽  
Judith M. Fonville ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Limit Of Detection ◽  
Point Of Care ◽  
High Sensitivity ◽  
The Novel ◽  
Limit Of Quantitation ◽  
Reference Limits ◽  
Males And Females

Abstract Objectives High sensitivity (hs) cardiac troponin (cTn) assays are defined per the IFCC Committee on Clinical Application of Cardiac Biomarker (C-CB) by the ability to measure ≥ 50% of concentrations greater than the limit of detection (LoD) with an impression of ≤10% at sex-specific 99th percentiles. Our study determined the sex-specific 99th percentile upper reference limits for males and females utilizing heparinized plasma from AACC universal sample bank for the Siemens point of care (POC) Atellica® VTLi hs-cTnI immunoassay. Methods Apparently healthy subjects, included overall 693, males 363, and females 330, following exclusionary surrogate biomarker use of hemoglobin A1c, NT-proBNP, and eGFR, along with statin medication. hs-cTnI was measured in a central laboratory, on multiple POC Atellica® VTLi immunoassay analyzers. The LoD was 1.24 ng/L and limit of quantitation (CV 20%) was 6.7 ng/L. 99th percentile URLs were determined by the nonparametric (NP) method. Results Histograms of the hs-cTnI concentrations (ng/L) for males and females were used to visualize the distributions and concentrations in men and women and differed significantly (pre- and post-exclusion, both p <0.001). 99th percentile URLs were: overall 23 ng/L (90% CI 20–32 ng/L); male 27 ng/L (CI 21–37 ng/L); female 18 ng/L (CI 9–78 ng/L). The percentages of subjects having a measurable concentration ≥ the LoD were: overall 83.7%, male 87.3%, female 79.7%. Conclusions Our findings show the novel POC Atellica® VTLi hs-cTnI assay meets the designation of a ‘high-sensitivity’ assay using heparinized plasma.

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