scholarly journals Diagnostic Challenges on the Laboratory Detection of Lupus Anticoagulant

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 844
Author(s):  
Armando Tripodi
Keyword(s):  
Lupus Anticoagulant ◽  
Clinical Laboratory ◽  
External Quality Assessment ◽  
State Of The Art ◽  
Diagnostic Procedures ◽  
External Quality ◽  
Glycoprotein I ◽  
Current State ◽  
Clinical Laboratories

Lupus anticoagulant (LA) is one of the three laboratory parameters (the others being antibodies to either cardiolipin or β2-glycoprotein I) which defines the rare but potentially devastating condition known as antiphospholipid syndrome (APS). Testing for LA is a challenging task for the clinical laboratory because specific tests for its detection are not available. However, proper LA detection is paramount for patients’ management, as its persistent positivity in the presence of (previous or current) thrombotic events, candidate for long term anticoagulation. Guidelines for LA detection have been established and updated over the last two decades. Implementation of these guidelines across laboratories and participation to external quality assessment schemes are required to help standardize the diagnostic procedures and help clinicians for appropriate management of APS. This article aims to review the current state of the art and the challenges that clinical laboratories incur in the detection of LA.

scholarly journals External quality assessment programs: Past, present and future

2005 ◽  
Vol 24 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Mario Plebani
Keyword(s):  
Quality Evaluation ◽  
External Quality Assessment ◽  
State Of The Art ◽  
Future Perspectives ◽  
External Quality ◽  
Quality Of Control ◽  
Clinical Laboratories ◽  
Growing Body ◽  
Analytical Errors

External Quality Assurance (EQA) and Proficiency Testing (PT) programs are fundamental tools for quality evaluation and improvement in clinical laboratories. A growing body of evidence has been collected to demonstrate the usefulness of these programs for reducing inter-laboratory variation, analytical errors and for improving the "state-of-the art". The validity of EQA/PT programs is strongly affected by the quality of control materials, the design of the program, namely the ability to estimate analytical bias and imprecision, and the commitment of providers to assist in the education participant laboratories. Future perspectives of EQA/PT are the possibility to evaluate pre- and post-analytical steps, the utilization of Internet for receiving and communicating results to participant laboratories and the accreditation/certification of the programs. .

scholarly journals Spanish society of laboratory medicine external quality assurance programmes: evolution of the analytical performance of clinical laboratories over 30 years and comparison with other programmes

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Carmen Perich ◽  
Carmen Ricós ◽  
Fernando Marqués ◽  
Joana Minchinela ◽  
Angel Salas ◽  
...  
Keyword(s):  
Quality Assurance ◽  
State Of The Art ◽  
Laboratory Medicine ◽  
Analytical Performance ◽  
External Quality Assurance ◽  
Biological Variability ◽  
External Quality ◽  
Spanish Society ◽  
Clinical Laboratories ◽  
Quality Specifications

AbstractThe purpose of this study is to understand the evolution of the analytical performance of the laboratories participating in the Spanish society of laboratory medicine (SEQCML) external quality assurance (EQA) programmes during its 30 years of operation and to compare it with the performance of other EQA programmes to establish whether the results are similar. The results obtained during this period are evaluated by applying the biological variability (BV) and state of the art-derived quality specifications. In addition, the results are compared with those obtained by other EQA programme organisations. It is noted that the laboratories participating in the EQA–SEQCML programmes have improved their performance over 30 years of experience and that the specifications derived from biological variation are achievable. It is difficult to compare EQA programmes, due to lack of accessibility and the differences in the design of these programmes (control materials, calculations used and analytical specifications established). The data from this study show that for some biological magnitudes the results obtained by the programmes are not yet harmonised, although efforts are being made to achieve this. Organisers of EQA programmes should also join the harmonisation effort by providing information on their results to enable comparison.

Limitations of Proficiency Testing Under CLIA '67

1992 ◽  
Vol 38 (7) ◽  
pp. 1237-1244 ◽  
Author(s):  
R H Laessig ◽  
S S Ehrmeyer ◽  
B J Lanphear ◽  
B J Burmeister ◽  
D J Hassemer
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Proficiency Testing ◽  
Clinical Laboratory ◽  
Health Care Financing ◽  
Clinical Laboratories ◽  
Regulatory Strategy ◽  
Clinical Laboratory Improvement Amendments ◽  
Quality Improvement Tool

Abstract Proficiency testing (PT), recognized as a quality-assurance (QA) and quality-improvement tool, also has become the cornerstone of the Health Care Financing Administration's (HCFA) regulatory strategy under the revised Clinical Laboratory Improvement Act of 1967 (CLIA '67) and the proposed Clinical Laboratory Improvement Amendments of 1988 (CLIA '88). Use of PT as a regulatory tool corrupts it for things it can do better. PT as a primary regulatory strategy has severe limitations. We explore the nature of these limitations and their implications for clinical laboratories as they impact on the long-term success of HCFA's approved regulatory PT programs in 1991 and beyond, and CLIA '88 PT, which is to be implemented in 1994.

Improvement in the performance of external quality assessment in Korean HIV clinical laboratories using unrecalcified human plasma

2012 ◽  
Vol 50 (9) ◽  
Author(s):  
Jin-Sook Wang ◽  
Mee-Kyung Kee ◽  
Byeong-Sun Choi ◽  
Chan-Wha Kim ◽  
Hyon-Suk Kim ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Hiv Testing ◽  
Human Plasma ◽  
External Quality Assessment ◽  
External Quality ◽  
Testing Laboratories ◽  
Clinical Laboratories ◽  
Immunodeficiency Virus ◽  
Acid Citrate Dextrose ◽  
Citrate Dextrose

AbstractThe external quality assessment schemes (EQAS) organizer provides a suitable program to monitor and improve the quality of human immunodeficiency virus (HIV) testing laboratories with EQAS panels prepared under various conditions. The aim of the current study was to investigate the effects of human plasma samples on the EQAS results of HIV obtained from hospital-based clinical laboratories.From 2007 to 2009, HIV EQAS panels consisted of four to six samples that consisted of undiluted positive and negative samples and were provided to laboratories twice per year. Up until the first half EQAS in 2008, EQAS panel materials were obtained by converting acid citrate dextrose treated plasma to serum via chemical treatment with CaClApproximately 300 HIV clinical laboratories participated in this program. The overall performance of clinical laboratories was shown to be improved when using unrecalcified plasma panels compared with recalcified panels. Significant differences were observed in EIA analyses of plasma for both positive (p<0.001) and negative (p<0.001) samples between the recalcified and unrecalcified groups.Our finding suggested that defibrination status of EQAS panels might affect the results of anti-HIV EQAS of Korean HIV testing laboratories.

Lupus anticoagulant: case-based external quality assessment

2009 ◽  
Vol 62 (8) ◽  
pp. 731-734
Author(s):  
A M H P van den Besselaar ◽  
K M J Devreese ◽  
P G de Groot ◽  
A Castel
Keyword(s):  
Quality Assessment ◽  
Lupus Anticoagulant ◽  
External Quality Assessment ◽  
External Quality ◽  
Case Based

Combined international external quality assessment results of medical laboratory performance and reporting of samples with known antimicrobial resistance

Diagnosis ◽  
2018 ◽  
Vol 5 (3) ◽  
pp. 161-166
Author(s):  
Michael A. Noble ◽  
Robert Rennie
Keyword(s):  
Antimicrobial Resistance ◽  
Quality Assessment ◽  
Clinical Laboratory ◽  
External Quality Assessment ◽  
Medical Laboratory ◽  
External Quality ◽  
Laboratory Performance ◽  
Reporting Practices ◽  
Medical Laboratories ◽  
Poor Treatment

Abstract Background Reporting on the presence of antimicrobial resistance is of considerable concern both for individual patient care and for understanding the underlying health status within the community at large. Antimicrobial resistance is solely dependent upon clinical laboratory detection and thus can be impacted upon by the quality and competence of medical laboratories. Proficiency testing or external quality assessment (PT/EQA) is the international standard for the direct measurement of medical laboratory performance on critical testing. Methods An international, intercontinental collaborative retrospective study of medical laboratory performance in antibiotic resistance was performed by the Microbiology Working Group (MWG) of the European Organisation for External Quality Assurance for Laboratory Medicine (EQALM) with particular examination of laboratory performance on the testing and reporting of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and carbapenem-resistant Enterobacteriaceae (CRE). Results The results of 1880 medical laboratories were compiled. Strictly accurate reporting of isolates as resistant occurred with MRSA 96.9%, with VRE 91.3% and with CRE 93.1% of the time. On the other hand, very major errors (reporting of false susceptibility) were observed with 2.2% of MRSA and 2.4% of VRE and 0.8% of CRE. Major errors (false resistance) were reported for vancomycin susceptibility testing for MRSA at a rate of 0.6%. Conclusions Depending on how clinical physicians read and understand microbiology susceptibility reports, proficient acceptable results were reported either between 91% and 94% of the time, or between 97% and 100%. While very major errors are infrequently reported, they were found in all regions and could potentially cause poor treatment decisions by clinicians. A collective analysis of multi-program PT/EQA information can provide valuable insights into the testing and reporting practices of medical laboratories.

Advanced Laser Diode Cooling Concepts

2008 ◽  
Vol 1076 ◽  
Author(s):  
Ryan Feeler ◽  
Jeremy Junghans ◽  
Edward Stephens ◽  
Greg Kemner ◽  
Fred Barlow ◽  
...  
Keyword(s):  
Laser Diode ◽  
Thermal Performance ◽  
Materials Science ◽  
State Of The Art ◽  
Power Laser ◽  
Current State ◽  
Laser Diode Arrays ◽  
High Power Laser Diode ◽  
Better Than

ABSTRACTA new, patent-pending method of cooling high-power laser diode arrays has been developed which leverages advances in several areas of materials science and manufacturing. This method utilizes multi-layer ceramic microchannel coolers with small (100's of microns) integral water channels to cool the laser diode bar. This approach is similar to the current state-of-the-art method of cooling laser diode bars with copper microchannel coolers. However, the multi-layer ceramic coolers offer many advantages over the copper coolers, including reliability and manufacturing flexibility. The ceramic coolers do not require the use of deionized water as is mandatory of high-thermal-performance copper coolers.Experimental and modeled data is presented that demonstrates thermal performance equal to or better than copper microchannel coolers that are commercially available. Results of long-term, high-flow tests are also presented to demonstrate the resistance of the ceramic coolers to erosion. The materials selected for these coolers allow for the laser diode bars to be mounted using eutectic AuSn solder. This approach allows for maximum solder bond integrity over the life of the part.

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