Sample Integrity and Preanalytical Variables

Adcock, Dorothy M.

doi:10.1002/9781118543467.ch5

Cited by 6 publications

(13 citation statements)

References 45 publications

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“…41 How shall we design evaluation studies adequately addressing the analytical accuracy and technical performance of a laboratory test, and how do we select suitable performance criteria? I argue that two critical criteria must be taken into account to generate informative results: (1) what is the clinical question to be answered and (2) what is the adequate experimental design for the specific analytical method? Uniform checklists considering only the number of samples might grossly overestimate technical performance obtained in routine laboratory practice.…”

Section: Phase 1: Technical Performancementioning

confidence: 99%

“…Preanalytical issues are regarded as the most frequent source of error in laboratory medicine. 1,42 The preanalytical phase is consequently the second issue to be studied in evaluation projects. It covers specimen collection, sample processing (e.g., centrifugation), transportation, as well as storage.…”

Section: Phase 2: Preanalytical Factorsmentioning

confidence: 99%

“…Tests conducted in the hemostasis laboratory are particularly susceptible to preanalytical artifacts due to the activation of platelets, activation factors, as well as inhibitors. 1 A large number of such factors were found to affect hemostasis tests which included misidentification of samples, traumatic blood drawing, drawing from vascular access devices, incomplete distribution of anticoagulant within the tube, underfilling of tubes, vigorous shaking, use of very small and large needles, use of activating collection containers, use of anticoagulants other than citrate, tourniquet use, pneumatic tube transport, long processing times, and incorrect centrifugation schemes. Thus, evaluation projects should adequately address all aspects of sample handling and processing.…”

Section: Phase 2: Preanalytical Factorsmentioning

confidence: 99%

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Translating Laboratory Tests into Clinical Practice: A Conceptual Framework

Nagler

2020

Hamostaseologie

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The use of laboratory biomarkers in clinical practice is rapidly increasing. Laboratory tests are, however, rarely evaluated adequately before implementation, and the utility of many tests is essentially unclear. An important reason for this knowledge gap is that a comprehensive and generally accepted methodological framework supporting evaluation studies is essentially lacking. Researchers, clinicians, and decision-makers are often not aware of the methodological tools available and face problems with the appraisal of a test's utility. With the present article, I aim to summarize current concepts and methodological tools and propose a framework for a phased approach that could be used in future evaluation projects. Future research will refine this suggested framework by identifying problems in current evaluation projects, specifying methodological criteria for all phases, as well as developing advanced methodological tools.

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Section: Phase 1: Technical Performancementioning

confidence: 99%

Section: Phase 2: Preanalytical Factorsmentioning

confidence: 99%

Section: Phase 2: Preanalytical Factorsmentioning

confidence: 99%

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Translating Laboratory Tests into Clinical Practice: A Conceptual Framework

Nagler

2020

Hamostaseologie

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“…Each laboratory should have defined criteria for rejecting unsuitable specimens for coagulation testing. Samples that do not arrive in appropriate timeframe for analysis (see chapter: Sample storage until analysis), unlabelled or mislabelled specimens, clotted specimens, specimens collected in the test tube with a wrong anticoagulant or those with inadequate blood to anticoagulant ratio, grossly haemolysed specimens and specimens that were refrigerated before testing should be rejected ( 8 , 11 , 16 ).…”

Section: Preanalytical Phase In Coagulation Testingmentioning

confidence: 99%

Croatian Society of Medical Biochemistry and Laboratory Medicine: National recommendations for blood collection, processing, performance and reporting of results for coagulation screening assays prothrombin time, activated partial thromboplastin time

Bronić¹,

Herak

Margetić³

et al. 2019

Biochem. med. (Online)

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A modern diagnostic laboratory offers wide spectrum of coagulation assays utilized in the diagnosis and management of patients with haemostatic disorders, preoperative screening and anticoagulation therapy monitoring. The recent survey conducted among Croatian medical biochemistry and transfusion laboratories showed the existence of different practice policies in particular phases of laboratory process during coagulation testing and highlighted areas that need improvement. Lack of assay standardization together with non-harmonized test results between different measurement methods, can potentially lead to incorrect decisions in patient’s treatment. Consequently, patient safety could be compromised. Therefore, recommended procedures related to preanalytical, analytical and postanalytical phases of prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dimer testing are provided in this review, aiming to help laboratories to generate accurate and reliable test results.

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“…18 Plasma samples were collected after ethylenediaminetetraacetic acid (EDTA) and serum samples to avoid contamination with residual heparin or tissue factor if blood was accidentally obtained from a vascular access device or using a butterfly needle. 12,19,21 Venous blood was drawn into two plastic syringes of 4.5 mL containing 0.106 mol/L trisodium citrate (Monovette, Sarstedt, Nümbrecht, Germany). Samples were transported immediately to the central laboratory and the handling of both samples was identical.…”

Section: Collection and Handling Of Samplesmentioning

confidence: 99%

Rapid Centrifugation in the Routine Hemostasis Laboratory

Wolfensberger

Georgiou²,

Giabbani

et al. 2019

Thromb Haemost

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Background The use of short and uniform centrifugation schemes contributes significantly to the successful automation of laboratory procedures. It is however unclear if this is applicable to the hemostasis laboratory. Objectives This article assesses the accuracy of measurements obtained with a rapid, high-speed centrifugation scheme in a large set of hemostasis tests, covering the full spectrum of values obtained in clinical practice, and using meaningful statistical measures. Methods Two citrated plasma samples were obtained from consecutive patients of a tertiary hospital with suspected abnormal hemostasis tests and processed with two centrifugation schemes in parallel: 1,500 × g for 10 minutes and 3,137 × g for 7 minutes. The following tests were conducted: prothrombin time (n = 125), international normalized ratio (n = 146), activated partial thromboplastin time (n = 119), thrombin time (n = 105), fibrinogen (n = 125), factor (F)II (n = 69), FV (n = 64), FVII (n = 64), FX (n = 67), FVIII (n = 55), FIX (n = 37), FXI (n = 35), and FXIII (n = 20), D-dimer (n = 34), antithrombin (n = 31), anti-Xa activity (n = 30), von Willebrand antigen (n = 25), and von Willebrand activity (VWF:GPIbM; n = 27). Results A wide range of results were obtained in all tests. Spearman's rank correlation coefficient was at least 0.95 for all tests except FV, FIX, and FXI. The coverage probability π at a given deviation index κ of 15% was above 0.9 for all tests except FV, FVII, FX, FVIII, FIX, FXI, and VWF:GPIbM, suggesting a lack of agreement. Conclusion Our results suggest that high-speed centrifugation is applicable to the majority of routine hemostasis parameters. The coverage probability was more sensitive than Spearman's rank correlation to detect disagreement among centrifugation schemes.

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Sample Integrity and Preanalytical Variables

Cited by 6 publications

References 45 publications

Translating Laboratory Tests into Clinical Practice: A Conceptual Framework

Translating Laboratory Tests into Clinical Practice: A Conceptual Framework

Croatian Society of Medical Biochemistry and Laboratory Medicine: National recommendations for blood collection, processing, performance and reporting of results for coagulation screening assays prothrombin time, activated partial thromboplastin time

Rapid Centrifugation in the Routine Hemostasis Laboratory

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