scholarly journals Vitamin D: Current Challenges between the Laboratory and Clinical Practice

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1758
Author(s):  
Ludmila Máčová ◽  
Marie Bičíková
Keyword(s):  
Vitamin D ◽  
Normal Values ◽  
External Quality Assessment ◽  
Healthy Population ◽  
External Quality ◽  
Clinical Laboratories ◽  
Routine Measurement ◽  
Growing Body ◽  
High Degree ◽  
Significant Interference

Vitamin D is a micronutrient with pleiotropic effects in humans. Due to sedentary lifestyles and increasing time spent indoors, a growing body of research is revealing that vitamin D deficiency is a global problem. Despite the routine measurement of vitamin D in clinical laboratories and many years of efforts, methods of vitamin D analysis have yet to be standardized and are burdened with significant difficulties. This review summarizes several key analytical and clinical challenges that accompany the current methods for measuring vitamin D. According to an external quality assessment, methods and laboratories still produce a high degree of variability. Structurally similar metabolites are a source of significant interference. Furthermore, there is still no consensus on the normal values of vitamin D in a healthy population. These and other problems discussed herein can be a source of inconsistency in the results of research studies.

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 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.

Establishing an Accuracy Basis for the Vitamin D External Quality Assessment Scheme (DEQAS)

2017 ◽  
Vol 100 (5) ◽  
pp. 1277-1287 ◽  
Author(s):  
Carolyn Q Burdette ◽  
Johanna E Camara ◽  
Federica Nalin ◽  
Jeanita Pritchett ◽  
Lane C Sander ◽  
...  
Keyword(s):  
Vitamin D ◽  
Quality Assessment ◽  
External Quality Assessment ◽  
Measurement Procedure ◽  
Binding Assays ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Hydroxyvitamin D ◽  
Target Values ◽  
High Concentrations

Abstract Until recently, the Vitamin D External Quality Assessment Scheme (DEQAS) assessed the performance of various assays for the determination of serum total 25-hydroxyvitamin D [25(OH)D] by using a consensus mean based on the all-laboratory trimmed mean (ALTM) of the approximately 1000 participants' results. Since October 2012, the National Institute of Standardsand Technology (NIST), as part of the Vitamin D Standardization Program, has participated in DEQAS by analyzing the quarterly serum sample sets using an isotope dilution LC-tandem MS (ID LC-MS/MS) reference measurement procedure to assign an accuracy-based target value for serum total 25(OH)D. NIST has analyzed90 DEQAS samples (18 exercises × 5 samples/exercise) to assign target values. The NIST-assigned values are compared with the ALTM and the biases assessed for various assays used by the participants, e.g., LC-MS/MS, HPLC, and several ligand-binding assays. The NIST-value assignment process and the resultsof the analyses of the 90 DEQAS samples are summarized. The absolute mean bias between the NIST-assignedvalues and the ALTM was 5.6%, with 10% of the samples having biases >10%. Benefits of the accuracy-based target values are presented, including for sample sets with high concentrations of 25(OH)D2 and 3-epi-25(OH)D3.

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.

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