Impact of Proposed HRI s on Laboratory Report Flagging Rates
|
|
|
- Antony Blankenship
- 5 years ago
- Views:
Transcription
1 Impact of Proposed HRI s on Laboratory Report Flagging Rates A/Prof. Ken Sikaris Melbourne Pathology BSc(Hons), MBBS, FRCPA, FAACB, FFSc
2 CBN 2011 WORKSHOP 2012 WORKSHOP 2013 WORKSHOP 2014
3 GENERAL CONCEPTS WORKSHOPS A; Ca/Phos/Mg/Urate B; LD/Lipase/Chol/Trig/HDLC C; U&E D; LFT PAEDIATRIC/PREGNANCY WORKSHOPS E; Paediatrics F; Pregnancy
4
5 GENERAL UPDATES BREAKOUT SESSIONS A: Alb/Glob/ALT/AST/GGT/BR B: CK/Ca/Urate/Bicarb/Urea C: Paediatrics D: Decision Limits (Lipids/Glu) FINAL CONSIDERATIONS Adults Paediatrics Decision Limits TRACEABILITY TEST PROFILES IRONS STUDIES CRITICAL VALUES PUTS DRUGS LIPIDS CLINICAL: ALT/AST/GGT/Urate
6 Analyte Male Female Calcium mmol/l Calcium (albumin adjusted) mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l ALP <40 U/L <35 U/L ALT* <40 U/L <30 U/L Total Protein g/l *Albumin (BCP/Immunoassay) g/l *Globulins (BCP/Immunoassay Alb) g/l *Total Bilirubin <21 umol/l *Lipase A/Prof Ken Sikaris April U/L AST* *GGT (IFCC) 30th umol/l <50 U/L <35 U/L <66 U/L
7 BREAKOUT SESSIONS A: B: C: D:
8 Why reference limits? Why flags?
9 Unaffected Affected 0.5 SPECIFICITY SENSITIVITY Tumour Marker Level 100 PRIORITIZE SENSITIVITY
10 Unaffected Affected 0.5 SPECIFICITY SENSITIVITY Tumour Marker Level 100 PRIORITIZE SPECIFICITY
11 SENSITIVITY 0.5 Unaffected Affected Tumour Marker Level 100 PRIORITIZE SPECIFICITY
12
13 Unaffected Affected 0.5 SPECIFICITY SENSITIVITY Good NPV Bad PPV Tumour Marker Level 100 PRIORITIZE SENSITIVITY
14 Unaffected Affected 0.5 SPECIFICITY SENSITIVITY Fair NPV Good PPV Tumour Marker Level 100 PRIORITIZE SPECIFICITY
15 Reference Intervals Default classification Minimise false positives in healthy 95% specificity 99% specificity?
16 Bivariate 95% (most Ref Int) 95% 95% 2.5% 2.5%
17 Bivariate 99% (hstnt?, CA125?) >99% 99% 0.5% 0.5%
18 Univariate 99% (hstnt?, CA125?) 99% 1.0%
19 Univariate 95% (TBil, ALT, AST, GGT) 95% 5.0%
20 ISO Report Content The report shall include, but be limited to, the following (j) Biological reference intervals or diagrams/nomograms supporting clinical decision values, where applicable.
21 Validation of Reference Intervals (1)
22 Harmonised Reference Intervals What is necessary: Appropriate reference Intervals Evidence exists showing that: Methods are the same. Populations are the same. The quality of common reference intervals depends on the quality of evidence used to derive them.
23 Validation of Reference Intervals (2) N=20 18 (90%) or more must fall into reference interval N=20,000?? 18,000 (90%) or more must fall into reference interval??
24
25 Number of Patients Thousands Flag Rates % 2.86% Sodium mmol/l
26 Laboratory Databases (Nov 2013) Outpatients, Singlicate (98-99%), F 16+, M 18+ SNP (Abbott Architect) n=24,700 DHM (Abbott Architect)) n=39,000 Clinpath (Roche C701) n=20,000 Melb Path (Roche C701) n=20,000
27 SNP Flag Rates (Architect) SNP SNP SNP n Low High Analyte Range Units Sodium mmol/l % 0.15% Potassium mmol/l % 1.35% Chloride mmol/l % 1.58% Bicarbonate mmol/l % 0.18% Creatinine (M) umol/l % 4.73% Creatinine (F) umol/l % 2.65% Calcium mmol/l % 1.88% Calcium' mmol/l % 1.57% Phosphate mmol/l % 1.46% Magnesium mmol/l % 0.17% LDH U/L % 9.66% ALP U/L % 10.98% Total Protein g/l % 1.86% 2.8% 2.9%
28 DHM Flag Rates (Architect) DHM DHM DHM n Low High Analyte Range Units Sodium mmol/l % 0.39% Potassium mmol/l % 3.27% Chloride mmol/l % 1.16% Bicarbonate mmol/l % 0.11% Creatinine (M) umol/l % 4.58% Creatinine (F) umol/l % 2.22% Calcium mmol/l % 2.36% Calcium' mmol/l % 2.06% Phosphate mmol/l % 3.22% Magnesium mmol/l % 0.52% LDH U/L % 11.58% ALP U/L % 8.89% Total Protein g/l % 3.40% 2.1% 3.4%
29 Clinpath Flag Rates (Roche) ClinPath ClinPath ClinPath n Low High Analyte Range Units Sodium mmol/l % 1.13% Potassium mmol/l % 3.90% Chloride mmol/l % 0.19% Bicarbonate mmol/l % 1.19% Creatinine (M) umol/l % 3.62% Creatinine (F) umol/l % 2.24% Calcium mmol/l % 1.05% Calcium' mmol/l Phosphate mmol/l % 2.44% Magnesium mmol/l LDH U/L % 9.43% ALP U/L % 9.09% Total Protein g/l % 2.26% 2.1% 3.3%
30 Melb Path Flag Rates (Roche) MP MP MP Low High Analyte Range Units Sodium mmol/l % 2.86% Potassium mmol/l % 3.95% Chloride mmol/l % 0.21% Bicarbonate mmol/l % 0.84% Creatinine (M) umol/l % 3.81% Creatinine (F) umol/l % 2.08% Calcium mmol/l % 1.42% Calcium' mmol/l % 2.00% Phosphate mmol/l % 3.36% Magnesium mmol/l 5.39% 2.79% LDH U/L ALP U/L % 9.06% Total Protein g/l % 1.64% 2.0% 2.8%
31 Total Protein ALP LDH Clinpath Magnesium Abbott Phosphate DHM Calcium' Calcium SNP Creatinine (F) Creatinine (M) 15% Bicarbonate Chloride Potassium Sodium % Flag Low Flags 20% MP Roche 10% 5% 0%
32 Total Protein ALP LDH Clinpath Magnesium Abbott Phosphate DHM Calcium' Calcium SNP Creatinine (F) Creatinine (M) Bicarbonate Chloride Potassium Sodium % Flag High Flags 15% MP Roche 10% 5% 0%
33 Other Laboratory Databases (2014) Dorevitch (Advia) (Courtesy Nilika Wijaratne) n=40,000 Laverty (Advia) (Courtesy Chris Farrell) n=50,000 Laverty (Integra) N=50,000
34 Protein ALP LD Magnesium Advia Phos LAV Corrected Ca Calcium DOR Creatinine M Creatinine F Bicarbonate Chloride K Sodium % Flag Low Flags 15% LAV Integra Roche 10% 5% 0%
35 Protein ALP LD Magnesium Advia Phos LAV Corrected Ca Calcium DOR Creatinine M Creatinine F Bicarbonate Chloride K Sodium % Flag High Flags 15% LAV Integra Roche 10% 5% 0%
36 Low Flags 20% % Flag 15% SNP DHM ClinPath MP Abbott Roche DOR LAV Advia INTEGRA Roche 10% 5% Protein ALP LD Magnesium Phos Corrected Ca Calcium Creatinine M Creatinine F Bicarbonate Chloride K Sodium 0%
37 High Flags 15% SNP DHM ClinPath MP Abbott Roche DOR LAV Advia INTEGRA Roche % Flag 10% 5% Protein ALP LD Magnesium Phos Corrected Ca Calcium Creatinine M Creatinine F Bicarbonate Chloride K Sodium 0%
38 Analyte Male Female Calcium mmol/l Calcium (albumin adjusted) mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l ALP U/L AST* <40 U/L <35 U/L ALT* <40 U/L <30 U/L Total Protein g/l *Albumin (BCP/Immunoassay) g/l *Globulins (BCP/Immunoassay Alb) g/l *Total Bilirubin <21 umol/l *GGT (IFCC) *Lipase umol/l <50 U/L <35 U/L <66 U/L
39 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Sodium 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte
40 Na mmol/l
41 Na mmol/l
42 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Potassium 10.0% Low High 7.5% 5.0% Private Labs 5.4/ % 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte
43 Potassium mmol/l
44 Potassium mmol/l
45 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Chloride 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte
46 Chloride mmol/l
47 Chloride mmol/l
48 Proposed Reference Intervals Female mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l 20.0% 17.5% 10.0% Calcium mmol/l 7.5% Phosphate mmol/l 5.0% Magnesium mmol/l 2.5% LD [L to P] (IFCC) U/L 0.0% ALP U/L High 12.5% mmol/l g/l Low 15.0% Calcium Total Protein Abbott Sodium Bicarbonate SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte NZ Labs 29/31
49 HCO mmol/l
50 HCO mmol/l
51 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Creatinine (F) 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte
52 Creatinine (F) umol/l
53 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Creatinine (M) 10.0% Low 7.5% High Sonic >60y/o 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte NZ Labs 100/105
54 Creatinine (M) umol/l
55 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Calcium 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte
56 Total calcium
57 Total calcium
58 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Calcium Corrected 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte NZ
59 Corrected calcium
60 Corrected calcium
61 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Phosphate 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte NZ 0.80/1.55
62 PO4
63 PO4
64 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Magnesium 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte StV/NZ Lower/1.0
65 Proposed Reference Intervals Male Female LD Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l 12.5% Bicarbonate mmol/l 10.0% umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Low % Flag Creatinine 15.0% High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Analyte NZ
66 LD
67 LD
68 Proposed Reference Intervals Male Female ALP Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l 12.5% Bicarbonate mmol/l 10.0% umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l Low % Flag Creatinine 15.0% High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Analyte NZ , , Age, Gender
69 ALP
70 ALP
71 Proposed Reference Intervals Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) U/L ALP U/L Total Protein g/l PROTEIN 10.0% Low High 7.5% 5.0% 2.5% 0.0% SNP DHM ClinPath MP DOR LAV INTEGRA SNP DHM ClinPath MP DOR LAV INTEGRA Male % Flag Analyte NZ 60/65/66-80/82/84/87
72 Total protein
73 Total protein
74 Proposed Reference Intervals Analyte Male Female Sodium mmol/l Potassium (serum) mmol/l Chloride mmol/l Bicarbonate mmol/l Creatinine umol/l umol/l Calcium mmol/l Calcium mmol/l Phosphate mmol/l Magnesium mmol/l LD [L to P] (IFCC) ALP Total Protein U/L U/L g/l
75 Conclusions Flag rates are generally about 2 3% Flag rates are highly consistent with similar equipment platforms studied (r2=0.89) Flags rates are generally consistent across platforms studied (r2=0.48) Objections: Physiological (gender/age) Clinical (clinical classification) Increased specificity (decrease flag) Increased sensitivity (higher flag) Historical (effort / benefit)
Harmonisation of Reference Ranges
Harmonisation of Reference Ranges Ken Sikaris BSc(Hons), MBBS, FRCPA, FAACB, FFSc Vice President, AACB (Education) Chemical Pathologist, Melbourne Pathology Director of Clinical Support Systems, Sonic
Reference Intervals. Graham Jones / Gus Koerbin
Reference Intervals Graham Jones / Gus Koerbin Adult CRI - Harmonisation Harmonisation 1 2012: (13 tests + 1 calculation) Harmonisation 2 2013: Confirm 2012 recommendations. Discussed: albumin, globulin,
Evidence Based Commutability: Bias 2 Study. Janice Gill Manager RCPAQAP Chemical Pathology Adelaide SA
Evidence Based Commutability: Bias 2 Study Janice Gill Manager RCPAQAP Chemical Pathology Adelaide SA Australian Bias Studies conducted by Gus Koerbin, ACT Pathology on behalf of AACB Harmonisation Committee
Quality Initiative In Pathology. Harmonisation of Laboratory Testing
Quality Initiative In Pathology Harmonisation of Laboratory Testing Harmonisation: what do we mean? Agreement of test results irrespective of the method used or the testing laboratory Requires: Common
The Whats and Hows of Reference Intervals. Graham Jones Department of Chemical Pathology St Vincent s Hospital, Sydney
The Whats and Hows of Reference Intervals Graham Jones Department of Chemical Pathology St Vincent s Hospital, Sydney Surabaya Indonesia 2016 Acknowledgements Reference Intervals - Summary What are they
Breakout Session C: Harmonisation of the Alert Table.
Breakout Session C: Harmonisation of the Alert Table. RCPA-AACB High Risk Results Working Party Andrew Georgiou Craig Campbell Grahame Caldwell Hans Schneider Penelope Coates Que Lam Rita Horvath Robert
Narelle Hadlow, Peter Ward, Ken Sikaris
Narelle Hadlow, Peter Ward, Ken Sikaris Analytes for consideration Vascular, renal and Na and water changes Consider physiology and review data Na, K, Cl, Urea, Cr, Osm Acid base status Consider physiology
Serodos and Serodos plus
Design Verification Serodos and Serodos plus Contents 1 Value Adjustment... 2 2 Target Determination... 2 3 Stability... 2 Real-Time Stability... 3 Stability after Reconstitution... 4 Stability after Reconstitution
Confirmation - A Practical Approach
Data Mining i for Reference Interval Confirmation - A Practical Approach Graham Jones Chemical Pathologist St Vincent s Hospital, Sydney AACB Webinar 5 th June 2013 Summary A little (more) background Current
Authorised: JSWoodford, Lead of Speciality. Biochemistry Reference Intervals, October Page 1 of 5
AFP All All < 15 ug/l Albumin All 0-3M 25-40 g/l Albumin All 3-12M 32-45 g/l Albumin All 1-70Y 34-48 g/l Albumin All >70Y 32-46 g/l Alk Phos All 0-10Y 80-350 U/L Alk Phos M 10-14Y 45-400 U/L Alk Phos F
Setting of quality standards
Setting of quality standards Graham Jones Department of Chemical Pathology St Vincent s Hospital, Sydney AACB ASM Adelaide October 2014 Setting of Quality Standards - 2013 The 2013 QC workshop revealed
General Chemistry Scheme Guide
General Chemistry Scheme Guide Copyright WEQAS. All rights reserved. No part of this document may be reproduced or utilised in any form without permission from WEQAS Contents. Scheme details and repertoire.....
AUSTRALIAN PATHOLOGY UNITS AND TERMINOLOGY (APUTS) Harmonised Reference Intervals Chemical Pathology. (v1.1)
AUSTRALIAN PATHOLOGY UNITS AND TERMINOLOGY (APUTS) Harmonised Reference Intervals Chemical Pathology (v1.1) ISBN: Pending 1 State Health Publication Number (SHPN): Pending Online copyright RCPA 2014 This
Global Report #01 27/11/2013. Patient percentile monitoring compared to internal quality control (IQC) monitoring
Patient Percentile Monitoring Global Report #01 CONTENT Project status Patient percentile monitoring compared to internal quality control (IQC) monitoring Comparison of outpatient/all patient monitoring
ROTUNDA HOSPITAL DEPARTMENT OF LABORATORY MEDICINE
This active test table informs the user of Biochemistry tests available in house. s referred to other sites are recorded in the Referred Table. Issue date: 4 TH April 2016 Contact Phone Number ext.1345/2522
Chemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-25 U/L 10-35 U/L 10-30 U/L 10-25 U/L 10-30 U/L 10-35 U/L 10-25 U/L 10-35 U/L 10-25 U/L 10-20 U/L 10-35 U/L Albumin 0-6
Chemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-30 U/L 10-30 U/L 10-20 U/L Albumin 0-6 days 6 days - 37 months 37 months - 7 years 7-20 years 2.6-3.6 g/dl 3.4-4.2 g/dl
Evaluation of VACUETTE CAT Serum Fast Separator Blood Collection Tube for Routine Chemistry Analytes in Comparison to VACUTAINER RST Tube
Evaluation of VACUETTE CAT Serum Fast Separator Blood Collection Tube for Routine Chemistry Analytes in Comparison to VACUTAINER RST Tube Background: Greiner-Bio-One, Austria has been selling plastic evacuated
Stability of VACUETTE Lithium Heparin Separator tubes with modified centrifugation conditions
Stability of VACUETTE Lithium Heparin Separator tubes with modified centrifugation conditions Background: Greiner-Bio-One, Austria has been selling plastic evacuated tubes (VACUETTE ) for venous blood
Traceability in External Quality Assessment: How Weqas ensures traceability in EQA and stresses its importance to users. David Ducroq.
Traceability in External Quality Assessment: How Weqas ensures traceability in EQA and stresses its importance to users David Ducroq Weqas Unit 6, Parc Tŷ Glas Llanishen Cardiff UK www.weqas.com Programme
Paediatric reference intervals an update. Tina Yen Harmonisation Workshop Sydney 18 th May 2017
Paediatric reference intervals an update Tina Yen Harmonisation Workshop Sydney 18 th May 2017 Meeting of the AACB Paediatric SIG Tuesday 16 th May 2017 Prof Frank Bowling (NSW/ TAS) Prof Rita Horvath
BIOCHEMICAL REPORT. Parameters Unit Finding Normal Value. Lipase U/L Amylase U/L
Lipase U/L 88.9 10-195 Amylase U/L 1181.1 371.3-1192.6 West Delhi :- 7/148, Opp. MCD Office, Major Pankaj Batra Marg, Near Ramesh Nagar, New Delhi-15, Ph. : 011-47562566,9999830187 Liver Function Test
What tests should be on the Alert List?
What tests should be on the Alert List? Dr Que Lam On behalf RCPA-AACB High Risk Results Working Party: Alan McNeil, Grahame Caldwell, Craig Campbell, Penelope Coates, Robert Flatman, Andrew Georgiou,
Comparison of VACUETTE Heparin Gel Tubes for Common Chemistry Analytes
Comparison of VACUETTE Heparin Gel Tubes for Common Chemistry Analytes Background: Greiner-Bio-One, Austria has been selling plastic evacuated tubes (VACUETTE ) for venous blood collection since 9. The
Biochemistry Adult Reference Ranges
Certified correct on 28/06/2016 Biochemistry Adult Reference Ranges Test Reference range Units Reference range from Traceable to standard reference material Albumin 35 50 g/l Pathology IRMM ERM-DA470k/IFCC
SydPath Reference Intervals for Clinical Trials (Contract Pathology Unit) Unauthorised Copy
HAEMATOLOGY APTT 1 150 M 25 35 sec APTT 1 150 F 25 35 sec Basophils Cord 2 weeks M 0.0 0.4 10^9/L Basophils Cord 2 weeks F 0.0 0.4 10^9/L Basophils 2 wks 3 mths M 0.0 0.2 10^9/L Basophils 2 wks 3 mths
Why Traceability Matters to Patients?
Why Traceability Matters to Patients? (and you are all patients) Graham Jones Department of Chemical Pathology St Vincent s Hospital, Sydney JCTLM Members and Stakeholders meeting, Paris 2017 Acknowledgements
GENERAL. Compulsory module GEN II Example questions (Acute and Routine Clinical Chemistry)
GENERAL Compulsory module GEN II Example questions (Acute and Routine Clinical Chemistry) ESSAY ANSWER QUESTIONS 2 Questions - each question is worth 35 marks.all questions should be attempted Question
Evaluation of new MiniCollect Z Serum (Separator) Tubes
Evaluation of new MiniCollect Z Serum (Separator) Tubes Background: Greiner Bio-One has developed a newly designed MiniCollect tube offering an integrated collection scoop. The advantage of the new tube
REFERENCE INTERVALS. Units Canine Feline Bovine Equine Porcine Ovine
REFERENCE INTERVALS Biochemistry Units Canine Feline Bovine Equine Porcine Ovine Sodium mmol/l 144-151 149-156 135-151 135-148 140-150 143-151 Potassium mmol/l 3.9-5.3 3.3-5.2 3.9-5.9 3.0-5.0 4.7-7.1 4.6-7.0
Seeing is not Believing (13-Nov-2004)
In: 55th Annual Meeting of the American College of Veterinary Pathologists (ACVP) & 39th Annual Meeting of the American Society of Clinical Pathology (ASVCP), ACVP and ASVCP (Eds.) Publisher: American
CALIBRATION SERUM LEVEL 3 (CAL 3)
CALIBRATION SERUM LEVEL 3 (CAL 3) CAT. NO. CAL 2351 LOT NO. 907UE SIZE: 20 x 5ml EXPIRY: 2019-07-28 GTIN: 05055273200966 INTENDED USE For use as a Calibrator in clinical chemistry assays. RANDOX Calibration
Coping with Analytical Interferences
Coping with Analytical Interferences (Handling Icteric, Hemolytic and Lipaemic Samples) Graham Jones Department of Chemical Pathology St Vincent s Hospital, Sydney Surabaya Indonesia 2016 Acknowledgements
CALIBRATION SERUM LEVEL 3 (CAL 3)
CALIBRATION SERUM LEVEL 3 (CAL 3) CAT. NO. CAL 2351 LOT NO. 709UE SIZE: 20 x 5ml EXP: 2016-12 INTENDED USE For use as a Calibrator in clinical chemistry assays. RANDOX Calibration Sera are based on lyophilised
10 Essential Blood Tests PART 1
Presents 10 Essential Blood Tests PART 1 The Blood Chemistry Webinars With DR. DICKEN WEATHERBY Creator of the Blood Chemistry Software Essential Blood Test #1: Basic Chem Screen and CBC http://bloodchemsoftware.com
External Quality Assessment for Calibration Laboratories in Laboratory Medicine - RELA -
External Quality Assessment for Calibration Laboratories in Laboratory Medicine - RELA - Anja Kessler Bonn, Germany 1 RELA Surveys www.dgkl-rfb.de 2 RELA Annual Process Each participant receives two different
Dr Bill Bartlett Blood Sciences, Ninewells Hospital & Medical School, NHS Tayside, Scotland, UK.
Dr Bill Bartlett Blood Sciences, Ninewells Hospital & Medical School, NHS Tayside, Scotland, UK. Bill.Bartlett@nhs.net www.biologicalvariation.com Biological variation affects the clinical utility of reference
Manufacturer Report for Siemens Unassayed Chemistry Lot Exp 30 Jun 2018
Acetaminophen Enzymatic, colorimetric µg/ml.09 0..0.09 0..0 0. 0. 0. 0. 9.. 9.0 0.9.0..9.. Albumin Bromcresol Purple (BCP) g/dl.0 0.0..0 0.00.. 0.0.. 0.09..9 0.0..9 0.0..0 0.0..0 0.0. Alkaline Phosphatase
NEW RCPCH REFERENCE RANGES-
s vary between populations and age groups and it is important to always check the reference Haematology: Haemoglobin Male 130 175 g/l 0 6 days 145-220 g/l Female 115 165 g/l 7 days 140-186 g/l 8 days 3
Supplementary materials
Supplementary materials Table S Adverse events identified by participants diary logs and blood hematologic and biochemical tests (n=2) group (n=) Placebo group (n=) P value for chi-squared test Asthma
Postanalytical phase
Postanalytical phase Test request POSTANALYTICAL Result interpretation PHASE Result Sampling Black box: the lab And the RESULT is created The technician approves the result; it is transferred to the lab
Australian and New Zealand College of Veterinary Scientists. Fellowship Examination. Veterinary Clinical Pathology Paper 1
Australian and New Zealand College of Veterinary Scientists Fellowship Examination June 2012 Veterinary Clinical Pathology Paper 1 Perusal time: Twenty (20) minutes Time allowed: Three (3) hours after
Evaluation Report of the Pneumatic Tube Transport System (PEVCO) connecting Dialysis Hospital to. Mubarak Hospital. Dr.
5 Evaluation Report of the Transport System (PEVCO) connecting Dialysis Hospital to Mubarak Hospital Dr. Anwar AlAnjeri Senior Registrar Clinical Biochemistry Laboratory Mubarak Hospital Introduction:
HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2)
0843 HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2) CAT. NO. HN1530 / HS2611 LOT NO. 899UN SIZE: 20 x 5ml / 5 x 5ml EXPIRY: 2018-02 INTENDED USE This product is intended for in vitro diagnostic
LIQUID ASSAYED CHEMISTRY CONTROL PREMIUM PLUS - LEVEL 1 (LIQ CHEM ASY PREMIUM PLUS 1)
0086 LIQUID ASSAYED CHEMISTRY CONTROL PREMIUM PLUS - LEVEL 1 (LIQ CHEM ASY PREMIUM PLUS 1) CAT. NO. LAL 4213 LOT NO. 238UL SIZE: 12 x 5 ml EXPIRY: 2018-04-28 GTIN: 05055273209006 INTENDED USE This product
CALIBRATION SERUM - LEVEL 2 (CAL 2)
CAT. NO. CAL 2350 LOT NO. 1242UN SIZE: 20 x 5ml EXPIRY: 2020-02-28 GTIN: 05055273200959 INTENDED USE For use as a Calibrator in clinical chemistry assays. RANDOX Calibration Sera are based on lyophilised
VITROS MicroSlide Assay Summary
ACET Acetaminophen ALB Albumin EDTA 10 9 TDM PV Specialty 5.5 4 PV Isotonic saline or 10 200 μg/ml 66 1323 μmol/l (μmol/l = μg/ml x 6.616) 1.00 6.00 g/dl 10.0-60.0 g/l (g/l = g/dl x 10) Therapeutic: 670
HUMAN ASSAYED MULTI-SERA - LEVEL 3 (HUM ASY CONTROL 3)
0086 HUMAN ASSAYED MULTI-SERA - LEVEL 3 (HUM ASY CONTROL 3) CAT. NO. HE1532 / HS2611 LOT NO. 789UE SIZE: 20 x 5ml / 5 x 5ml EXP: 2019-05 INTENDED USE This product is intended for in vitro diagnostic use
Controls & Calibrators Clinical Chemistry
Controls & Calibrators Clinical Chemistry Clinical Chemistry Controls & Lipids Clinical Chemistry and lipid quality controls have been manufactured from true human serum to ensure they perform the same
HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2)
0120 HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2) CAT. NO. HN1530 / HS2611 LOT NO. 995UN SIZE: 20 x 5ml / 5 x 5ml EXP: 2018-12 INTENDED USE This product is intended for in vitro diagnostic use,
Faculty/Presenter Disclosure I WOULD NEVER ORDER THAT FOR THAT PERSON; LAB USE AND MISUSE IN ALBERTA 19/10/2016
I WOULD NEVER ORDER THAT FOR THAT PERSON; LAB USE AND MISUSE IN ALBERTA Trefor Higgins DynaLIFEDx Edmonton, Alberta Faculty/Presenter Disclosure Presenter: Trefor Higgins Relationships that may introduce
HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2)
0086 HUMAN ASSAYED MULTI-SERA - LEVEL 2 (HUM ASY CONTROL 2) CAT. NO. HN1530 GTIN: 05055273203783 SIZE: 20 x 5ml CAT. NO. HS2611 GTIN: 05055273203813 SIZE: 5 x 5ml LOT NO. 1089UN EXPIRY: 2020-02-28 INTENDED
CERTIFICATE OF ACCREDITATION
CERTIFICATE OF ACCREDITATION In terms of section 22(2) (b) of the Accreditation for Conformity Assessment, Calibration and Good Laboratory Practice Act, 2006 (Act 19 of 2006), read with sections 23(1),
Total Cost of Ownership (TCO): An evidence-based approach to compare laboratory equipment
Total Cost of Ownership (TCO): An evidence-based approach to compare laboratory equipment P.C.G. Gontard 1, L.I. Stankevich 1, B.G. Gorodetsky 1 SUMMARY Clinical laboratories across the globe operate in
Test Profiles Time for a Change. Tony Badrick (AACB Harmonisation Committee)
Test Profiles Time for a Change Tony Badrick (AACB Harmonisation Committee) 1. Why Profiles 2. Profiles A. LFT B. Electrolyte C. Renal D. Bone 3. Summary Same clothes!! Harmonisation! Same car!! Harmonisation!
Questionnaire. Traceability in EQA. Traceability
Questionnaire in EQA QUESTIONNAIRE ON TRACEABILITY QUESTIONNAIRE ON TRACEABILITY GENERAL INFORMATION Name EQA organisation Country Specify the total number of measurands in the schemes of your EQA organisation
Understanding Blood Tests
PATIENT EDUCATION patienteducation.osumc.edu Your heart pumps the blood in your body through a system of blood vessels. Blood delivers oxygen and nutrients to all parts of the body. It also carries away
B. PANITUMUMAB DOSE LEVEL 0 No dose reduction 1 Level -1 2 Level Other, specify in comments for this cycle
Radiation Therapy Oncology Group Phase II Study Pre-operative Chemo- Radiation + Panitumumab for Potentially Operable Lung Cancer Concurrent Summary Form AMENDED DATA YES INSTRUCTIONS: Submit all pages
Schedule of Accreditation issued by United Kingdom Accreditation Service 2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK
2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK Biochemistry Department University Hospital of North Durham Durham County Durham DH1 5TW Contact: Dr Tim Lang Tel: +44 (0) 191 333 2694 Fax:
BASIC METABOLIC PANEL
Update 2/12/2018 BASIC METABOLIC PANEL CPT 80048 Stability: 3 days at 15-25 C; 7 days at 2-8 C; > 7 days at -70 C Colorimetric Assay, Rate reaction, ISE Components: BUN, Calcium, Chloride, CO2, Creatinine,
Please contact the Client Services Team if you require further information.
Reference ranges are quoted on all reports where appropriate for the test carried out. The reference range and reporting units, including any interpretive information, is specific to the methodology used
cobas c 501 analyzer and cobas c 311 analyzer Within Run Imprecision Guidelines
cobas c 501 analyzer and cobas c 311 analyzer General Information How to use these guidelines Unless otherwise indicated, the data presented is the same for both the cobas c 501 analyzer and the cobas
Australian and New Zealand College of Veterinary Scientists. Membership Examination. Small Animal Medicine Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2017 Small Animal Medicine Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
Schedule of Accreditation issued by United Kingdom Accreditation Service 2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK
2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK Spire Portsmouth Hospital Bartons Road Havant PO9 5NP United Kingdom Contact: Natalie Peck E-Mail: natalie.peck@spirehealthcare.com Website:
The order of draw - myth or science? Dr Mike Cornes: Principal Clinical Scientist Royal Wolverhampton NHS Trust
The order of draw - myth or science? Dr Mike Cornes: Principal Clinical Scientist Royal Wolverhampton NHS Trust Where is Wolverhampton? Samples Errors Where is Order of draw Important? Problems Associated
Venous Blood Gas Reference Intervals
Venous Blood Gas Reference Intervals The NSW Health Pathology approach Andrea Rita Horvath Department of Clinical Chemistry & Endocrinology NSW Health Pathology, Prince of Wales Hospital, Sydney andrea.horvath@health.nsw.gov.au
COMPANY OR UNIVERSITY
CONTRIBUTOR NAME Daniel Heinrich, DVM CONTRIBUTOR EMAIL dheinric@umn.edu COAUTHORS Jed Overmann, DVM, DACVP; Davis Seelig DVM, PhD, DACVP & Matthew Sturos, DVM COMPANY OR UNIVERSITY University of Minnesota
Provided by MedicalStudentExams.com NORMAL LABORATORY VALUES
NORMAL LABORATORY VALUES 1. BLOOD, PLASMA, SERUM 2. CEREBROSPINAL FLUID 3. HEMATOLOGIC 4. SWEAT 5. URINE 6. SYNOVIAL FLUID 7. TOXIC LEVELS 8. Tumour Markers 9. Differential of Cerebral Spinal Fluid 10.
Australian and New Zealand College of Veterinary Scientists. Membership Examination. Veterinary Pathology Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2014 Veterinary Pathology Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
Tables of Normal Values (As of February 2005)
Tables of Normal Values (As of February 2005) Note: Values and units of measurement listed in these Tables are derived from several resources. Substantial variation exists in the ranges quoted as normal
1.) 3 yr old FS Siamese cat: 3 day history of lethargy, anorexia. Dyspneic, thin, febrile.
1.) 3 yr old FS Siamese cat: 3 day history of lethargy, anorexia. Dyspneic, thin, febrile. NUCLEATED CELLS 19.5 High 4.0-14.0 x 10^3/ul METAMYELOCYTES 9 % 1.8 High 0.0-0.0 x 10^3/ul BAND NEUTROPHILS 61
Clinician Blood Panel Results
Page 1 of 8 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
Hamilton Regional Laboratory Medicine Program
Created: April 2002 of Review: February 2004 of Review: June 2006 of Review: July 2007, St. Joseph s Healthcare went live with Meditech as of June18, 2007. of Review: August 2009 of Review: December 2011;
The Use of Tests in Clinical Biochemistry Interpreting Blood Results. Rowland Reece Principal Clinical Biochemist St. Vincent s University Hospital
The Use of Tests in Clinical Biochemistry Interpreting Blood Results Rowland Reece Principal Clinical Biochemist St. Vincent s University Hospital Topic Headlines What is Clinical Biochemistry? How does
Recommended Nordic paediatric reference intervals for 21 common biochemical properties
Scandinavian Journal of Clinical & Laboratory Investigation, 2012; Early Online: 1 9 ORIGINAL ARTICLE Recommended Nordic paediatric reference intervals for 21 common biochemical properties LINDA HILSTED
Hamilton Regional Laboratory Medicine Program
Created: April 2002 of Review: February 2004 of Review: June 2006 of Review: July 2007, St. Joseph s Healthcare went live with Meditech as of June18, 2007. of Review: August 2009 of Review: December 2011;
MEMORANDUM. These reference ranges are effective immediately but sample requirements remain unchanged currently.
MEMORANDUM Originating Department Chemical Pathology Issued By: Issued To: Subject: Details: Dr. Shari Srinivasan All Laboratory Service Users Change in Chemical Pathology Analysers Dear Colleague, As
Fullerton Healthcare Screening Centres
Fullerton Healthcare Screening Centres Fullerton Healthcare Screening Centre @ Ngee Ann City The Penthouse, #26-02 Ngee Ann City Tower B, 391B Orchard Road, Singapore 238874 Operating hours: Monday - Friday
Schedule of Accreditation issued by United Kingdom Accreditation Service 2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK
2 Pine Trees, Chertsey Lane, Staines-upon-Thames, TW18 3HR, UK Spire Portsmouth Hospital Bartons Road Havant PO9 5NP United Kingdom Contact: Natalie Peck E-Mail: natalie.peck@spirehealthcare.com Website:
The positive side of overdiagnosis
The positive side of overdiagnosis Does an immediate comprehensive panel of laboratory tests in outpatient care improve patient outcomes? Bram Vrijsen, Maarten ten Berg, Christiana Naaktgeboren, Jolande
Biochemistry Department Laboratory Handbook
Biochemistry Department Laboratory Handbook Version : 3.3 Page 1 of 12 Table of contents Biochemistry Department... 1 Laboratory Handbook... 1 Introduction... 3 The Biochemistry Department... 3 High risk
TRACEABILITY and UNCERTAINTY
ACP Acid phosphatase total 1-naphthyl phosphate NPP Acid phosphatase, non-prostatic 1-naphthyl phosphate (Inhib.:tartrate) ACP-P Acid phosphatase, prostatic 1-naphthyl phosphate (Inhib.:tartrate) ALB Albumin
S Potassium K mmol/l Up to 1m m - 1y >1y /07/2010. S Chloride CL mmol/l Up to 3m > 3m /07/2010
Northumbria Healthcare NHS Trust Clinical Chemistry Deartment Reference Ranges Reference Ranges in use in Telepath Laboratory System at July 2005 unless indicated otherwise Last date Amended; 20/08/2010
Stability of common biochemical analytes in serum gel tubes subjected to various storage temperatures and times pre-centrifugation
Original Article Stability of common biochemical analytes in serum gel tubes subjected to various storage temperatures and times pre-centrifugation Melissa Tanner 1, Neil Kent 1, Brian Smith 2, Stephen
Module 7 Your Blood Work
Module 7 Your Blood Work Every month you will need to collect a sample of your blood just before you start dialysis, and depending on your doctor s recommendation, at the end of your dialysis treatment.
Clinician Blood Panel Results
Page 1 of 8 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement
TRACEABILITY and UNCERTAINTY
Cat. No. 0 79 0 90 ACP Acid phosphatase total -naphthyl phosphate NPP Acid phosphatase, non-prostatic -naphthyl phosphate (Inhib.:tartrate) ALB Albumin BCG plus ALB Albumin BCP ALP Alkaline phosphatase
Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS
Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation
REFERENCE INTERVALS OF COMMON CLINICAL CHEMISTRY ANALYTES FOR ADULTS IN HONG KONG
The Journal of the International Federation of Clinical Chemistry and Laboratory Medicine CHEMISTRY ANALYTES FOR ADULTS IN HONG KONG YC Lo 1, David A. Armbruster 2 1 Pamela Youde Nethersole Eastern Hospital,
Patient: 55 y female (ambulatory)
Disclosures Speaking Honoraria Radiometer (Canada) Nova Biomedical, Draeger Roche Diagnostics (Canada) Research Support (Reagents, Instrumentation, Travel) Nova Biomedical Abbott Laboratories (Canada)
FBC interpretation. Dr. Gergely Varga
FBC interpretation Dr. Gergely Varga #1 71 Y/O female, c/o weakness Test Undertaken : FBC (FBC) Sample Type: Whole Blood [ - 26.09.11 14:59] Hb 7.3 g/dl* 12.0-15.5 RBC 3.5 10^12/l * 3.80-5.60 Hct 0.24
CERTIFICATE OF ACCREDITATION
CERTIFICATE OF ACCREDITATION In terms of section 22(2) (b) of the Accreditation for Conformity Assessment, Calibration and Good Laboratory Practice Act, 2006 (Act 19 of 2006), read with sections 23(1),
ENROLLMENT CONFIRMATION
Step 1: Please review the Facility/Contact information. If any of the information is incorrect, please make the appropriate changes below: Facility/Contact Phone: (850)474-3660 Fax: (850)474-3659 6431
BC Biomedical Laboratories Adult Reference Ranges
BC Biomedical Laboratories Adult s Name Age 25 OH VITAMIN D Blood B 0-100 nmol/l Interpretation: < 25 Deficient 25-74 Insufficient 75-199 Sufficient > 200 Toxic 5HIAA (CALC) Urine B 0-100
WSLH. Calibration Verification/ Linearity Products. roficiency. esting. Products provided in partnership with:
WSLH PT roficiency esting Calibration Verification/ Linearity Products Products provided in partnership with: www.wslhpt.org 800-462-5261 PTService@slh.wisc.edu General Chemistry Ammonia/Ethanol - 5 x
NORMAL LABORATORY VALUES FOR CHILDREN
Pediatric Drug Lookup Normal Laboratory Values for NORMAL LABORATORY VALUES FOR CHILDREN CHEMISTRY Normal Values Albumin 0-1 y 2.0-4.0 g/dl 1 y to adult 3.5-5.5 g/dl Ammonia Newborns 90-150 mcg/dl 40-120
Complete Medical History
Lab Results for Ben Greenfield Last Test Date: Your medical history is not complete. Complete Medical History Complete Medical History What's Next Blood Draw Blood draw scheduled Complete your medical
ABNORMAL LIVER FUNCTION TESTS. Dr Uthayanan Chelvaratnam Hepatology Consultant North Bristol NHS Trust
ABNORMAL LIVER FUNCTION TESTS Dr Uthayanan Chelvaratnam Hepatology Consultant North Bristol NHS Trust INTRODUCTION Liver function tests Cases Non invasive fibrosis measurement Questions UK MORTALITY RATE
Color: Gray/Yellow. 5/7/2018 L Hematology results from IDEXX VetLab In-clinic Laboratory Requisition ID: 0 Posted Final Test Result Reference Range
5/7/2018 L LD AA-Urinalysis results from IDEXX VetLab In-clinic COLLECTION = free catch COLOR = yellow CLARITY = clear SP GR = 1.020 GLUCOSE = neg BILIRUBIN = neg KETONE = neg BLOOD = neg PH = 6.0 PROTEIN