Preanalytical variables and factors that interfere with the biochemical parameters: A review

uhadar, S

doi:10.13172/2052-0069-2-2-713

Cited by 20 publications

(20 citation statements)

References 25 publications

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“…Notably, our achievement in stabilizing surface marker expression and blood counts for up to 72 h surpasses the recommended storage duration set by the WHO by three- and sixfold, respectively 47 . The impact of these results on healthcare is significant; an estimated 46–68.2% of errors in laboratory testing are associated with the pre-analytical phase 48 , in which inadequate sample collection, handling, transportation, and storage are thought to be the major contributors to error 49 . Indeed, it has been reported that up to 54% of missing test results can be attributed to hemolysis alone 50 .…”

Section: Discussionmentioning

confidence: 99%

Whole blood stabilization for the microfluidic isolation and molecular characterization of circulating tumor cells

et al. 2017

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Precise rare-cell technologies require the blood to be processed immediately or be stabilized with fixatives. Such restrictions limit the translation of circulating tumor cell (CTC)-based liquid biopsy assays that provide accurate molecular data in guiding clinical decisions. Here we describe a method to preserve whole blood in its minimally altered state by combining hypothermic preservation with targeted strategies that counter cooling-induced platelet activation. Using this method, whole blood preserved for up to 72 h can be readily processed for microfluidic sorting without compromising CTC yield and viability. The tumor cells retain high-quality intact RNA suitable for single-cell RT-qPCR as well as RNA-Seq, enabling the reliable detection of cancer-specific transcripts including the androgen-receptor splice variant 7 in a cohort of prostate cancer patients with an overall concordance of 92% between fresh and preserved blood. This work will serve as a springboard for the dissemination of diverse blood-based diagnostics.

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Section: Discussionmentioning

confidence: 99%

Whole blood stabilization for the microfluidic isolation and molecular characterization of circulating tumor cells

et al. 2017

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“…Notably, untrained hospital staff (uneducated or have less than high school degrees) were transporting the samples. Studies showed that staff and trained phlebotomists make 2–4 times fewer pre-analytical errors than non-phlebotomists and lab staff [10]. A separate study showed that general practitioners and clinical hospital wards made about half of the pre-analytical errors [7].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan

Najat

2017

PLoS ONE

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BackgroundLaboratory testing is roughly divided into three phases: a pre-analytical phase, an analytical phase and a post-analytical phase. Most analytical errors have been attributed to the analytical phase. However, recent studies have shown that up to 70% of analytical errors reflect the pre-analytical phase. The pre-analytical phase comprises all processes from the time a laboratory request is made by a physician until the specimen is analyzed at the lab. Generally, the pre-analytical phase includes patient preparation, specimen transportation, specimen collection and storage. In the present study, we report the first comprehensive assessment of the frequency and types of pre-analytical errors at the Sulaimani diagnostic labs in Iraqi Kurdistan.Materials and MethodsOver 2 months, 5500 venous blood samples were observed in 10 public diagnostic labs of Sulaimani City. The percentages of rejected samples and types of sample inappropriateness were evaluated. The percentage of each of the following pre-analytical errors were recorded: delay in sample transportation, clotted samples, expired reagents, hemolyzed samples, samples not on ice, incorrect sample identification, insufficient sample, tube broken in centrifuge, request procedure errors, sample mix-ups, communication conflicts, misinterpreted orders, lipemic samples, contaminated samples and missed physician’s request orders. The difference between the relative frequencies of errors observed in the hospitals considered was tested using a proportional Z test. In particular, the survey aimed to discover whether analytical errors were recorded and examine the types of platforms used in the selected diagnostic labs.ResultsThe analysis showed a high prevalence of improper sample handling during the pre-analytical phase. In appropriate samples, the percentage error was as high as 39%. The major reasons for rejection were hemolyzed samples (9%), incorrect sample identification (8%) and clotted samples (6%). Most quality control schemes at Sulaimani hospitals focus only on the analytical phase, and none of the pre-analytical errors were recorded. Interestingly, none of the labs were internationally accredited; therefore, corrective actions are needed at these hospitals to ensure better health outcomes. Internal and External Quality Assessment Schemes (EQAS) for the pre-analytical phase at Sulaimani clinical laboratories should be implemented at public hospitals. Furthermore, lab personnel, particularly phlebotomists, need continuous training on the importance of sample quality to obtain accurate test results.

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“…Jaffé reaction may also be affected by lipemia and/or haemolysis. Haemolysed samples that contain fetal haemoglobin (HbF) interfere with the Jaffé reaction, and it is possible to obtain negative creatinine results ( 24 ). Management of lipemic samples was extensively explained in the review by Nikolac et al ( 25 ).…”

Section: Creatininementioning

confidence: 99%

The role of laboratory testing in detection and classification of chronic kidney disease: national recommendations

Biljak

Honović²,

Matica

et al. 2017

Biochem Med

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Chronic kidney disease (CKD) is a common clinical condition with significant adverse consequences for the patient and it is recognized as a significant public health problem. The role of laboratory medicine in diagnosis and management of CKD is of great importance: the diagnosis and staging are based on estimation of glomerular filtration rate (eGFR) and assessment of albuminuria (or proteinuria). Therefore, the joint working group of the Croatian society of medical biochemistry and laboratory medicine and Croatian chamber of medical biochemists for laboratory diagnostics in CKD issued this national recommendation regarding laboratory diagnostics of CKD. Key factors for laboratories implementing the national guidelines for the diagnosis and management of CKD are: 1. Ensure good communication between laboratory professionals and clinicians, such as nephrologists or specialists in general/family medicine, 2. Ensure all patients are provided with the same availability of laboratory diagnostics, 3. Ensure creatinine assays are traceable to isotope dilution mass spectrometry (IDMS) method and have minimal bias and acceptable imprecision, 4. Select the appropriate GFR estimating formula. Recommended equation is the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) equation, 5. In reporting the key laboratory tests (creatinine, eGFR, urine albumin-to-creatinine ratio, urine protein-to-creatinine ratio) use the appropriate reporting units, 6. Provide adequate information on limitations of creatinine measurement. The manuscript has been organized to identify critical points in laboratory tests used in basic laboratory diagnostics of CKD and is based on the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

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Preanalytical variables and factors that interfere with the biochemical parameters: A review

Cited by 20 publications

References 25 publications

Whole blood stabilization for the microfluidic isolation and molecular characterization of circulating tumor cells

Whole blood stabilization for the microfluidic isolation and molecular characterization of circulating tumor cells

Prevalence of Pre-Analytical Errors in Clinical Chemistry Diagnostic Labs in Sulaimani City of Iraqi Kurdistan

The role of laboratory testing in detection and classification of chronic kidney disease: national recommendations

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