Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine最新文献

{"title":"Impact of Total Protein and Triglycerides on the comparability of Sodium and Potassium Measurements by Direct and Indirect Ion-Selective Electrodes : An Experimental Analytical Study.","authors":"Parul Chopra, Ginni Bharti, Ankita Gupta, Shyam Prakash, Sudip Kumar Datta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Electrolyte analysers use ion selective electrode (ISE) technologies, either 'direct'(dISE) or 'indirect'(iISE). Indirect methods are susceptible to errors in samples with high protein or lipid content. This study evaluated the individual and combined effects of elevated total proteins(TP) and triglycerides(TG) on sodium(Na⁺) and potassium(K⁺) measurements.</p><p><strong>Methods: </strong>Fifty serum samples were pooled to prepare a low-protein, low-lipid matrix. Three enrichment series were generated using graded additions of 20% human albumin, 20% Intralipid, or both to achieve varying TP and TG. All samples were analysed for Na⁺ and K⁺ using dISE and iISE. The difference between methods (iISE-dISE) was correlated with TP and TG using regression and Bland-Altman analyses. A multivariable model assessed predictors of electrolyte bias.</p><p><strong>Results: </strong>Albumin addition produced negative sodium bias, reaching upto 10% at TP>13g/dL, while potassium changes remained small. Triglycerides caused marked sodium underestimation at high levels (>2000 mg/dL) with minimal effect on potassium levels. When both interferents were elevated, sodium disagreement was high (bias -5.4mmol/L; limits of agreement -19.1 to +8.2), reflecting a strong cumulative effect. Multivariable regression showed TP as the strongest predictor of Na⁺ bias (R² = 0.67), with minimal contribution by TG.</p><p><strong>Conclusion: </strong>This experimental study demonstrates that increasing concentrations of total protein and triglycerides, particularly when both are elevated produce significant negative biases in sodium measured by iISE, while potassium values remain comparable. These findings become clinically relevant in critical care/ cancer patients where they receive albumin and/or lipid infusions and dISE/iISE results are used interchangeably for patient monitoring.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"696-709"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-Specific Reference Intervals for Whole-Blood GSH/GSSG Ratio in Healthy Emirati Adults According to CLSI and ISO 15189 Guidelines.","authors":"Sushma Ravindra Umrao, Sampathkumar Elangovan, Muhammad Raza Qureshi, Muhammad Masoud Alam, Farhan Ashraf, Shafaath Husain Syed Mohammed, Mohamed Sayed Tharammal, Faiz Ul Amin, Mohammed Munir Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The glutathione redox system, expressed as the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSG), is a key indicator of cellular oxidative status. Manufacturer-provided reference intervals are typically derived from non-local populations and may not be applicable across different ethnic and geographic groups.</p><p><strong>Objective: </strong>To characterize the distribution of whole-blood GSH/GSSG ratio in healthy Emirati adults using ultra-high-performance liquid chromatography (UHPLC) and to establish population-specific reference intervals in accordance with CLSI C28-A3 and ISO 15189 guidelines.</p><p><strong>Methods: </strong>In this cross-sectional study, whole-blood samples from 120 apparently healthy Emirati adults were analyzed using a commercial UHPLC assay. The GSH/GSSG ratio was calculated for each participant. Due to non-normal distribution, reference intervals were derived using a nonparametric approach. Both the conventional 95% reference interval (2.5th-97.5th percentiles) and the central 90% interval (5th-95th percentiles) were calculated. Bootstrap resampling (20,000 iterations) was used to estimate 95% confidence intervals for the central 90% limits.</p><p><strong>Results: </strong>The GSH/GSSG ratio demonstrated a right-skewed distribution with a median (IQR) of 4.76 (3.58-6.77). Most participants (89.2%) had values below the manufacturer-reported reference interval (10-15), with only 5.0% within this range. The nonparametric 95% reference interval was 1.66-28.40. The central 90% interval was 2.53-17.20, with bootstrap 95% confidence intervals of 2.21-2.97 (lower) and 14.92-19.73 (upper).</p><p><strong>Conclusion: </strong>Manufacturer-provided reference intervals do not reflect the distribution observed in healthy Emirati adults. Population-specific reference intervals are therefore necessary. Reporting both 95% and 90% intervals, supported by bootstrap estimates, enhances clinical interpretation for both diagnostic and screening applications.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"686-695"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Pump Inhibitor (PPI)-Domperidone Induced Anemia and Galactorrhea: A Case Report.","authors":"Rupali Bains, Sudhahar Tamizhan, Priyanka Patra, Uttam Kumar Nath, Manisha Naithani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gastrointestinal disorders are increasingly common among young adults, particularly medical students exposed to chronic stress and irregular dietary habits. Proton pump inhibitors (PPIs) are widely prescribed for the management of gastroesophageal reflux disease (GERD), gastritis, and related acid-peptic disorders. However, prolonged PPI therapy has been associated with impaired iron absorption and may contribute to iron deficiency anemia (IDA). We report the case of 26-year-old female, unmarried, postgraduate medical student with iron deficiency anaemia and galactorrhea. The patient presented to gastroenterology clinic with a complaint of mild non-colicky epigastric pain, nausea, fatigue and shortness of breath. Comprehensive evaluation included complete blood count with peripheral smear, iron profile study, stool routine and stool for occult blood, serum IgA anti TTG, viral markers, upper gastro intestinal endoscopy (UGIE) & biopsy, H. Pylori ammonia breath test, gastric emptying scintigraphy, USG abdomen and pelvis, and serum prolactin levels. Based on the clinical, laboratory, and radiological findings, a diagnosis of iron deficiency anemia secondary to long-term PPI use and domperidone-induced galactorrhea was established. The patient was treated with intravenous ferric carboxymaltose (1500 mg), advised discontinuation of PPI-domperidone therapy, and initiated on a low-FODMAP diet. Significant clinical and hematological improvement was observed on follow-up, along with resolution of galactorrhea. Although PPIs remain highly effective and generally safe agents for acid suppression, concerns regarding their long-term adverse effects are increasing. Iron deficiency anemia resulting from chronic PPI use and concurrent domperidone-induced galactorrhea occurring in the same patient is rarely reported. This case underscores the importance of meticulous history taking, appropriate diagnostic evaluation, and rational test utilization in identifying uncommon medication-related adverse effects. Clinicians should consider prolonged PPI use as a potential contributing factor when evaluating unexplained iron deficiency anemia, particularly in young individuals receiving long-term therapy.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"771-776"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Truth Lies Within the Gap.","authors":"Shaun Tan, Alex Yong, Sharon Saw, Sunil Sethi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case in which a post-analytical transcription error in serum osmolality led to diagnostic delay and unnecessary investigations in a patient with hyponatremia. The principal learning point of this case is that discrepancy between measured and calculated osmolality-the osmolal gap-was critical to detecting the error and redirecting the diagnostic evaluation. A 68-year-old female with a past medical history of hyperlipidemia, hypertension and type 2 diabetes mellitus, was scheduled for inpatient open reduction and internal fixation of a right distal radius fracture under the Hand surgery service. She was referred to the endocrinologists in view of persistent hyponatremia. Pre-operatively, her serum sodium was 128mmol/L (reference interval 135-145mmol/L), potassium was 4.2mmol/L (3.5-5mmol/L), urea was 4.8mmol/L (2.0-6.5mmol/L), random glucose was 5.2mmol/L (4.0-7.8mmol/L) and measured osmolality was 296 mOsm/Kg (275-300 mOsm/Kg). Records of her previous serum sodium trend were reviewed, and all were within the normal reference interval since 2011. In this case, the serum osmolality was within our laboratory's normal reference interval albeit at the higher end at 296 mOsm/Kg. The initial clinical impression at this point of time was thus normo-osmolar pseudohyponatremia. The clinical pathologist's opinion was requested, and the patient's serum sodium was further evaluated on the RAPIDLab® 1200 Systems Siemens blood gas analyser. This returned a similar sodium result of 128 mmol/L, excluding the possibility of electrolyte exclusion effect on the initial indirect ISE (Beckman Coulter, CA, USA). Upon further investigation, it showed that the osmolal gap was spuriously elevated (30mOsm/kg) due to a transcription error for the measured osmolality, hence confounding the true aetiology of hyponatremia. This case has shown that prompt communication between laboratory professionals and physicians will assist in resolving clinically discordant results. The osmolal gap, in particular, served as a useful adjunct in working up an ambiguous cause of hyponatremia.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"759-766"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the Limit of Detection for Serum Ethanol: Evidence from a Clinical Laboratory.","authors":"José Arnau Pulido, Alejandra Pérez, Yolanda Fernández-Cladera, María Doladé, Susana Malumbres, Carla Fernández-Prendes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ethanol is a widely consumed psychoactive substance. Serum concentrations above 100 mg/dL can cause cognitive impairment and confusion, while levels exceeding 300 mg/dL may be fatal. Thus, rapid and accurate determination of blood ethanol concentration is crucial for diagnosing and managing acute intoxication. Ethanol measurement also has important legal implications, such as in traffic accidents or criminal proceedings. Gas Chromatography-Mass Spectrometry (GC-MS) is the reference method for ethanol determination due to its accuracy and specificity. In routine clinical laboratories, however, ethanol quantification is usually performed using enzymatic spectrophotometric assays. Alcohol dehydrogenase (ADH) oxidizes ethanol to acetaldehyde with NAD as coenzyme, which is simultaneously reduced to NADH. The increase in NADH absorbance at 340 nm allows indirect quantification of ethanol. Although analytical characterization and method optimization are the manufacturers' responsibilities, literature indicates these processes are not standardized, and specific procedures are generally not disclosed. Consequently, clinical laboratories may need to verify these values, particularly during implementation of new methods, internal validation, or when analytical results conflict with clinical presentation. We report four cases in our laboratory with positive ethanol results of 11-14 mg/dL that, after reprocessing, were reported as \"not detected\". This highlights the need to determine the smallest analyte quantity detectable with certainty, commonly expressed as the limit of detection (LoD).</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"589-591"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Glucose Stability Effect Between Citrate-sodium Fluoride-EDTA, Heparin, and Sodium Fluoride Containing Tubes: A Prospective Experimental Study in the Biochemistry Laboratory at the University Clinic of Kinshasa, DR Congo.","authors":"Ongona Sheko Nounou, Ngole Mamy, Pambu Dahlia, Tshibuela Beya Dophie, Beya Michael, Mukadi Patrick","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tubes containing sodium fluoride (NaF) are no longer recommended for measuring blood glucose levels. This prospective experimental study was conducted at the Biochemistry Laboratory of the University Clinics of Kinshasa, in the Democratic Republic of the Congo, and included seventy healthy volunteer blood donors. Glucose stability was assessed in tubes containing NaF, lithium heparinised tubes, and a tube containing a mixture of citrate, NaF and EDTA. The tubes containing citrate and NaF were stored at room temperature, whilst the corresponding heparinised tubes were placed on ice. Glucose measurements were taken at various time points (H0, H2, H24, H48) on centrifuged plasma kept in contact with blood cells. The citrate showed the highest and most stable glucose values over time, with virtually no loss of glucose. Lower glucose values were observed at H0 and H2 with the NaF (p < 0.05).Transporting the heparin tube on ice combined with centrifugation at +4°C resulted in higher blood glucose values than the NaF at time points H0 and H2 (p < 0.05), although lower than the citrate(p < 0.05);however, these values could not be maintained beyond 24 hours. Positive biases exceeding the desirable bias (1.8%) were observed between citrate and NaF tubes, as well as between heparinised and NaF tubes;this suggests a marked discrepancy and, consequently, a clinically significant difference between the various methods. For accurate blood glucose measurement, the citrate-NaF-EDTA tube is preferable in order to minimise glucose loss; however, a review of the diagnostic thresholds for diabetes mellitus must be carried out before its use. Cooling the sample is an effective alternative to compensate for the lack of citrate.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"621-631"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Rejected Samples in the Hematological Departments: A Comparison Between Palestinian Medical Complex Hospital and Hebron Governmental Hospital.","authors":"Lubna Mahmoud Habis, Mahmoud A Srour, Ola Karmi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Clinical laboratories play a vital role in diagnosis and management of patients. They use established protocols for sample collection and analysis, and several criteria to judge the quality of clinical samples intended for laboratory analysis. Two essential performance measures recommended for clinical laboratories are rejected samples and turnaround time (TAT), which have substantial clinical consequences for patient safety. This study evaluates these two measures in the hematological departments among the two biggest Palestinian Governmental Hospitals in the West Bank region, the Palestinian Medical Complex Hospital (PMCH), and the Hebron Governmental Hospital (HGH). This study is the first one to evaluate the rejected samples from Palestinian governmental hospitals.</p><p><strong>Methods: </strong>A retrospective analysis of rejected hematology samples was conducted over eight months (February-September 2023). Rejection frequencies, causes, and their influence on TAT were assessed according to the Ministry of Health guidelines.</p><p><strong>Results: </strong>PMCH exhibited a significantly higher rejection rate (2.1%) than HGH (1%), primarily due to clotted EDTA and Na-citrate tubes. The TAT for rejected samples was longer at HGH (over 10 hours) than at PMCH (5-6 hours).</p><p><strong>Conclusion: </strong>The study revealed a high specimen rejection rate, and prolonged TAT for EDTA samples, with approximately 40% of rejected samples not repeated within 24 hours. These findings provide baseline data to guide future quality improvement initiatives, staff training, and standardization of preanalytical procedures, ultimately enhancing laboratory quality and patient safety. Larger-scale studies are recommended to further investigate the factors contributing to sample rejection and inform corrective measures.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"609-620"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of NicCheck I Test Strips for the rapid detection of urine nicotine metabolites.","authors":"Seema Khattri Bhandari, James H Nichols","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use adversely affects surgical outcomes, prompting guidelines for preoperative smoking cessation. Accurate assessment of smoking status is critical, yet self-reporting is often unreliable. Biochemical verification via nicotine metabolites, particularly cotinine, offers objective evaluation. While mass spectrometry provides high sensitivity, point-of-care (POC) tests offer rapid, accessible alternatives. This study assesses the performance of NicCheck I, a CLIA-waived urine test, by comparing its results to liquid chromatography-tandem mass spectrometry (LC-MS/MS) for detecting tobacco exposure in surgical patients.</p><p><strong>Methods: </strong>Twenty-four frozen urine samples (12 cotinine-negative, 12 cotinine-positive) were analyzed using NicCheck I test strips and LC-MS/MS. Sample integrity, and pH were assessed using Siemens Multistix 10 SG reagent strips.</p><p><strong>Results: </strong>NicCheck I correctly identified all negative samples but detected nicotine metabolites in only 9 of 12 LC-MS/MS-confirmed positive samples. False negatives were associated with metabolite concentrations below the NicCheck I detection threshold (200 ng/mL) or urine pH outside the optimal range (4.5 - 8.5) consistent with manufacturer's package insert. LC-MS/MS demonstrated superior sensitivity.</p><p><strong>Conclusion: </strong>NicCheck I test strips provide a practical and same-day rapid screening tool for nicotine exposure in clinical settings prior to surgery, but the test is less sensitive than LC-MS/MS. NicCheck I test strip performance may be affected by abnormal urine pH.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"743-746"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Challenges in Point-of-Care Testing for Cardiac Biomarkers: Balancing Rapid Diagnosis with Clinical Responsibility.","authors":"Sibtain Ahmed, Melissa M Budelier, Nafija Serdarevic, Joesph Wiencek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapid expansion of point of care testing (POCT) has significantly transformed clinical decision-making, particularly in acute care settings. Cardiac biomarkers such as troponins (conventional and high sensitivity) and natriuretic peptides are increasingly being deployed at the bedside to expedite diagnosis and guide timely management [1]. While the clinical advantages of POCT are well recognized, its widespread implementation raises important ethical considerations that remain insufficiently addressed [2]. We aim to project that the rapid expansion of cardiac biomarker POCT has outpaced the development of practical ethical guidance for its implementation. In particular, challenges related to analytical reliability, accountability, quality oversight, equitable access, patient autonomy, and environmental sustainability require a structured ethical framework to support safe and clinically responsible use of POCT in cardiac care. One of the primary ethical concerns relates to the trade-off between speed and analytical accuracy. Although POCT offers faster turnaround times, variability in analytical performance compared to central laboratory assays may compromise diagnostic certainty [3]. This is particularly critical in the context of cardiac biomarkers, where even minor inaccuracies can lead to misclassification of myocardial infarction. In cardiac care, such errors carry particularly significant ethical implications because troponin results may directly influence urgent decisions regarding admission, invasive procedures, discharge, or withholding of treatment. This underscores the necessity of an ethical framework to ensure rapid testing does not compromise diagnostic integrity and patient safety.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"584-588"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Google Trends to Predict Dengue Outbreaks in Pakistan: A Time-Series and Causality Analysis.","authors":"Alizeh Sonia Fatimi, Tazeen Fatima, Asghar Nasir, Muhammad Shariq Shaikh, Imran Siddiqui, Sibtain Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Dengue fever is a significant public health issue in Pakistan. Seasonal outbreaks lead to considerable illness and economic strain. Traditional surveillance systems, like the Integrated Disease Surveillance and Response (IDSR) system, depend mainly on passive reporting. They often identify outbreaks only after transmission has already worsened. Digital data sources, such as Google Trends, might provide early signs of increasing disease activity by reflecting changes in public information-seeking behavior.</p><p><strong>Objective: </strong>To determine if Google search activity for dengue-related terms can predict dengue case counts in Pakistan during 2024.</p><p><strong>Methods: </strong>Weekly dengue case count data were collected from the IDSR Weekly Bulletin. Weekly Relative Search Volume (RSV) data for \"dengue,\" \"dengue fever,\" \"dengue symptoms,\" and \"dengue treatment\" were gathered from Google Trends. Case counts were adjusted to a 0-100 scale. Pearson correlation was used to examine the relationship between search activity and case count data. Time-series causality analysis was carried out using the Toda-Yamamoto method, following tests for stationarity and the specification of the Vector Autoregression (VAR) model.</p><p><strong>Results: </strong>Strong positive correlations were found between dengue-related search interest and case count data (r = 0.756-0.832; p < 0.001). The strongest correlation was for the term \"dengue.\" Toda-Yamamoto causality testing showed that search activity significantly predicted subsequent increases in dengue case counts for \"dengue symptoms\" (p = 0.004), \"dengue treatment\" (p = 0.001), and \"dengue\" (p = 0.004), with an approximate two-week lag.</p><p><strong>Conclusion: </strong>Google Trends search data effectively reflects and can anticipate dengue case count patterns in Pakistan. This suggests that it could serve as a cost-effective, real-time early warning tool to complement the national surveillance system. Combining digital search monitoring with IDSR reporting could lead to earlier detection and a more proactive public health response.</p>","PeriodicalId":37192,"journal":{"name":"Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine","volume":"37 4","pages":"677-685"},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}