Dried blood spots: Effects of less than optimal collection, shipping time, heat, and humidity

Abstract

Objectives: This study investigates how factors related to collection, storage, transport time, and environmental conditions affect the quality and accuracy of analyses of dried blood spot (DBS) samples. Methods: Data come from the 2016 Health and Retirement Study (HRS) DBS laboratory reports and the HRS merged with the National Climatic Data Center (NCDC) Global Historical Climate Network Daily (NCDC GHCN-Daily) and the NCDC Local Climatological Data, by zip code. We ran regression models to examine the associations between assay values based on DBS for five analytes (total cholesterol, high-density lipoprotein (HDL) cholesterol, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and cystatin C) and the characteristics of DBS cards and drops, shipping time, and temperature, and humidity at the time of collection. Results: We found cholesterol measures to be sensitive to many factors including small spots, shipping time, high temperature and humidity. Small spots in DBS cards are related to lower values across all analytes. Longer DBS transit time before freezing is associated with lower values of total and HDL cholesterol and cystatin C. Results were similar whether or not venous blood sample values were included in equations. Conclusions: Small spots, long shipping time, and exposure to high temperature and humidity need to be avoided if possible. Quality of spots and cards and information on shipping time and conditions should be coded with the data to make adjustments in values when necessary. The different results across analytes indicate that results cannot be generalized to all DBS assays.

Dried blood spot collection, sample quality, and fieldwork conditions: Structural validations for conversion into standard values

“…Recent work has shown that lab-based formulae used to transform DBS values into VBS-equivalent values do not address the fieldwork conditions that may affect the quality of DBS samples collected for an international survey like SHARE . This finding has been replicated in two field studies, which collected both VBS and DBS (Crimmins et al, 2020;.…”

“…An additional disadvantage of DBS is that results from DBS assays cannot be directly compared to the results one would obtain from assays of conventional VBS using standard laboratory methods (Crimmins et al, 2014; Karvanen, 2015; McDade, Williams, & Snoddgrass, 2007). Although there is variation in values obtained from analyses of VBS, the DBS values of, for example, total cholesterol, which is known to be particularly difficult to measure in DBS samples, have both a higher mean and a larger variance, influenced by many laboratory and fieldwork‐related factors (Thomas et al, 2018; Crimmins et al, 2020; Bowen & Evans, 2014. In: Li & Lee, 2014).…”

Measuring attack on self: The need for field‐friendly methods development and research on autoimmunity in human biology

“…Unfortunately, tests adapted for use with DBS using commercially available kits are subject to kit availability/production and reagent inconsistency, which, in many past cases, has limited their long‐term use (McDade, 2014). Further, Crimmins et al (2020) found that smaller spot size and longer periods of transit before freezing reduced the levels of some biomarkers. These findings suggest that factors that are often outside of researchers' control may increase variability of results from DBS methods.…”

The Evolving Role of Microsampling in Therapeutic Drug Monitoring of Monoclonal Antibodies in Inflammatory Diseases

“…It is particularly important that during the development and validation of novel analytical methods, the influence of relative humidity, the quality of microsamples, the type of filter paper and the temperature (during storage and shipment of the microsamples) are evaluated. Moreover, the stability of the analytes should be examined in all conditions that are expected to be met during the different stages of the microsamples handling [ 9 , 50 , 51 , 52 ]. Validated microsampling methods can promote patient-centric approaches in TDM of mAbs by reducing hospital visits and consequently the possibility of infection exposure, while enabling the clinicians to maintain the adequate patient control and the optimal individualized posology [ 41 , 53 , 54 , 55 , 56 ].…”