Journal of Applied Laboratory Medicine最新文献

{"title":"Associations between Growth Differentiation Factor 15, Cardiac Troponin T, and N-terminal pro-B-type Natriuretic Peptide, and Future Myocardial Fibrosis Assessed by Cardiac Magnetic Resonance Imaging: Data from the Akershus Cardiac Examination 1950 Study.","authors":"Thakshani Wimalanathan, Michael Fredrik Paus, Julia Brox Skranes, Trygve Berge, Arnljot Tveit, Helge Røsjø, Torbjørn Omland, Magnus Nakrem Lyngbakken, Siri Lagethon Heck","doi":"10.1093/jalm/jfae145","DOIUrl":"10.1093/jalm/jfae145","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is associated with a poor outcome for patients with cardiovascular disease (CVD). Growth differentiation factor 15 (GDF-15) concentrations predict the risk of death in patients with CVD, but the underlying pathophysiological mechanisms are poorly understood. We aimed to assess the associations between biomarkers of cellular stress and inflammation (GDF-15), cardiac injury (cardiac troponin T [cTnT]), and stretch (N-terminal pro-B-type natriuretic peptide [NT-proBNP]), and subsequent focal and diffuse myocardial fibrosis assessed by cardiac magnetic resonance (CMR) imaging.</p><p><strong>Methods: </strong>We measured GDF-15, cTnT, and NT-proBNP in 200 study participants without known coronary artery disease or renal dysfunction from the population-based Akershus Cardiac Examination 1950 Study at baseline in 2012 to 2015. Focal myocardial scars and diffuse fibrosis were assessed by late gadolinium enhancement imaging and septal extracellular volume fraction (ECV) by CMR 4 to 7 years later. The relationships between cardiac biomarkers and CMR parameters were assessed by logistic regression analysis adjusted for common cardiovascular risk factors.</p><p><strong>Results: </strong>The median age was 63.9 (interquartile range 63.4-64.5) years and 49% were women. GDF-15 (adjusted odds ratio [aOR] 4.40, 95% CI 1.09-17.72) and cTnT (aOR 1.59, 95% CI 1.01-2.50) were associated with nonischemic scars in the fully adjusted model. cTnT (aOR 2.45, 95% CI 1.41-4.25) and NT-proBNP (aOR 3.12, 95% CI 1.55-6.28) were associated with ischemic scars. None of the biomarkers were significantly associated with elevated ECV.</p><p><strong>Conclusions: </strong>In a general population cohort, GDF-15, an emerging biomarker of cellular stress and inflammation, associates with nonischemic scars. Biomarkers of myocardial injury and stretch associate with ischemic scars, while no biomarker was associated with diffuse fibrosis as assessed by CMR.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Augmented Kidney Stone Composition Analysis with Auto-Release Improves Quality, Efficiency, Cost-Effectiveness, and Staff Satisfaction.","authors":"Patrick L Day, Denise Rokke, Laura Schneider, Jillian Abbott, Brenda Holmen, Patrick Johnson, Mikolaj A Wieczorek, Katie L Kunze, Rickey E Carter, Joshua Bornhorst, Paul J Jannetto","doi":"10.1093/jalm/jfae146","DOIUrl":"https://doi.org/10.1093/jalm/jfae146","url":null,"abstract":"<p><strong>Background: </strong>We sought to evaluate key performance indicators related to an internally developed and deployed artificial intelligence (AI)-augmented kidney stone composition test system for potential improvements in test quality, efficiency, cost-effectiveness, and staff satisfaction.</p><p><strong>Methods: </strong>We compared quality, efficiency, staff satisfaction, and financial data from the 6 months after the AI-augmented laboratory test system was deployed (test period) with data from the same 6-month period in the previous year (control period) to determine if AI-augmentation improved key performance indicators of this laboratory test.</p><p><strong>Results: </strong>In the 6 months following the deployment (test period) of the AI-augmented kidney stone composition test system, 44 830 kidney stones were analyzed. Of these, 92% of kidney stones were eligible for AI-assisted interpretation. Out of these AI-eligible stones, 45% were able to be auto-released by the AI-augmented test system without human secondary review. Furthermore, the new AI-augmented kidney stone test system resulted in an apparent 40% reduction in incorrect laboratory results. Additionally, the new AI-augmented test system improved laboratory efficiency by 20%, improved staff satisfaction, and reduced the average analysis cost per kidney stone by $0.23.</p><p><strong>Conclusions: </strong>The AI-augmented test system improved test quality, efficiency, cost-effectiveness and staff satisfaction related to this kidney stone composition test.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Adherence to the PRISMA-DTA Guideline in Diagnostic Test Accuracy Systematic Reviews: A Five-Year Follow-up Analysis.","authors":"Jean-Paul Salameh, David Moher, Trevor A McGrath, Robert A Frank, Anahita Dehmoobad Sharifabadi, Nabil Islam, Eric Lam, Robert Adamo, Haben Dawit, Mohammed Kashif Al-Ghita, Brooke Levis, Brett D Thombs, Patrick M Bossuyt, Matthew D F McInnes","doi":"10.1093/jalm/jfae117","DOIUrl":"https://doi.org/10.1093/jalm/jfae117","url":null,"abstract":"<p><strong>Background: </strong>We evaluated reporting of diagnostic test accuracy (DTA) systematic reviews using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-DTA and PRISMA-DTA for abstracts.</p><p><strong>Methods: </strong>We searched MEDLINE for recent DTA systematic reviews (September 2023-Mar 2024) to achieve a sample size of 100. Analyses evaluated adherence to PRISMA-DTA (and abstracts), on a per-item basis. Association of reporting with journal, country, impact factor (IF), index-test type, subspecialty area, use of supplemental material, PRISMA citation, word count, and PRISMA adoption was evaluated. Comparison to the baseline evaluation from 2019 was done. Protocol: https://doi.org/10.17605/OSF.IO/P25TE.</p><p><strong>Results: </strong>Overall adherence (n = 100) was 78% (20.3/26.0 items, SD = 2.0) for PRISMA-DTA and 52% (5.7/11.0 items, SD = 1.6) for abstracts. Infrequently reported items (<33% of studies): eligibility criteria, definitions for data extraction, synthesis of results, and characteristics of the included studies. Infrequently reported items in abstracts were characteristics of the included studies, strengths and limitations, and funding. Reporting completeness for full text was minimally higher in studies in higher IF journals [20.7 vs 19.8 items; 95% confidence interval (95%CI) (0.09; 1.77)], as well as studies that cited PRISMA [21.1 vs 20.1 items; 95%CI (0.04; 1.95)], or used supplemental material (20.7 vs 19.2 items; 95%CI (0.63; 2.35)]. Variability in reporting was not associated with author country, journal, abstract word count limitations, PRISMA adoption, structured abstracts, study design, subspecialty, open-access status, or index test. No association with word counts was observed among full text or abstracts. Compared to the baseline evaluation, reporting was improved for full texts [71% to 78%; 95%CI (1.18; 2.26)] but not for abstracts [50% to 52%; 95%CI (-0.20; 0.60)].</p><p><strong>Conclusions: </strong>Compared to the baseline evaluation published in 2019, we observed modest improved adherence to PRISMA-DTA and no improvement in PRISMA-DTA for abstracts reporting.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Daratumumab from Endogenous Monoclonal Proteins in Serum from Multiple Myeloma Patients Using an Automated Mass Spectrometry System.","authors":"David Barnidge, Dhananjay Sakrikar, Tadeusz Kubicki, Benjamin A Derman, Andrzej J Jakubowiak, Gabriella Lakos","doi":"10.1093/jalm/jfae142","DOIUrl":"https://doi.org/10.1093/jalm/jfae142","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic monoclonal antibodies (t-mAbs) may interfere with electrophoresis-based methods used to monitor multiple myeloma (MM), which can create inaccurate results. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry is an alternative to gels distinguishing between endogenous M-proteins and t-mAbs based on molecular mass.</p><p><strong>Methods: </strong>Serum samples (n = 109) from 34 MM patients receiving Dara-KRd were collected 14 or 28 days postdaratumumab administration. Samples were analyzed using the EXENT® Analyzer that combines automated immunopurification and MALDI-TOF MS for the isotyping and quantification of monoclonal immunoglobulins.</p><p><strong>Results: </strong>Daratumumab was identified in 103 out of 109 samples (94.5%). In all IgGλ (n = 8), IgAκ (n = 8), and IgAλ (n = 2) patients, the M-protein and daratumumab were detected. Of the IgGκ patients (n = 18), 5 patients had a total of 6 samples where the M-protein was detected but daratumumab was not. There was no difference in the detection rate of daratumumab between samples taken 14 and 28 days postadministration with the median daratumumab concentration being 0.95 and 0.54 g/L, respectively. A precision study was also performed on 25 replicates containing 1 g/L daratumumab in serum where a coefficient of variation of 4.2% was observed as determined by the EXENT Analyzer.</p><p><strong>Conclusions: </strong>The Immunoglobulin Isotypes (GAM: IgG, IgA, and IgM) for the EXENT Analyzer detected and distinguished a daratumumab kappa light chain peak from an M-protein light chain peak in MM patient serum when resolved by the mass spectrometer.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Refrigeration to Immediate Room Temperature Testing for Uric Acid Monitoring in Rasburicase-Treated Patients.","authors":"Leo Lin, Michael Filtz, Jeffrey Wilson, Roscoe Errigo, Lauren M Zuromski, Anh Nguyen Sorenson, Brittany A Young","doi":"10.1093/jalm/jfae139","DOIUrl":"https://doi.org/10.1093/jalm/jfae139","url":null,"abstract":"<p><strong>Background: </strong>Rasburicase retains activity at room temperature (RT), so specimens collected for uric acid-level monitoring require cooling protocols. Our objective was to determine if we could ease these preanalytical requirements to improve compliance while maintaining accuracy.</p><p><strong>Methods: </strong>Fifty pairs of specimens were transported and stored either on ice or at RT. All were tested at 3 time points postcollection: immediately upon arrival to the laboratory (approximately 45 min), 90, and 135 min.</p><p><strong>Results: </strong>Uric acid concentrations are not clinically significantly different in RT or iced specimens, as long as specimens are tested within approximately 45 min postcollection. There was a negative bias in uric acid levels in a subset of specimens if they were held at RT and tested at 90 min (-9.1%) and 135 min (-17.5%). Specimens tested within 2 rasburicase half-lives postinfusion have an additional 24% decrease in uric acid levels if kept at RT for 90 min. Specimens from patients given a 6 mg dose had an 18% decrease in uric acid concentration compared to a 3 mg dose.</p><p><strong>Conclusions: </strong>Laboratories that can test uric acid levels rapidly after specimen collection may be able to validate alternative preanalytical methods to transporting and testing on ice.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Hemolysis on Routine Blood Gas and Whole Blood Analytes.","authors":"Bernice A Agana, Brian Overton, Katherine Florendo, Claire E Knezevic","doi":"10.1093/jalm/jfae140","DOIUrl":"https://doi.org/10.1093/jalm/jfae140","url":null,"abstract":"<p><strong>Background: </strong>Hemolysis is a major pre-analytical concern for many laboratory analytes; however, instruments utilized for whole blood chemistries and blood gas measurements lack the ability to detect and measure the degree of hemolysis. This study evaluated the effect of hemolysis on 13 routine whole blood and blood gas analytes and compared visual assessments of hemolysis to measured hemolysis (H-index).</p><p><strong>Methods: </strong>Remnant whole blood samples (n = 85) were split into 2 portions and aspirated through a syringe one or more times. To induce hemolysis, a needle was affixed to the end of the syringe to provide shear stress, and a mock procedure without syringe was used as a control. Samples were analyzed on a Radiometer ABL800 series instrument, centrifuged, and the H-index of the plasma portion was measured. Two medical technologists recorded a visual categorization of the specimens as slightly, moderately, or severely hemolyzed.</p><p><strong>Results: </strong>Hemolysis had a modest effect on metabolites and most cooximetry components, with percent bias within ±5% at all levels of hemolysis. Methemoglobin exhibited a larger overall negative bias, up to 13.3%. The absolute pH bias was fairly consistent (within 0.1 pH units) across all levels of hemolysis. As expected, potassium displayed a significant positive bias with increasing hemolysis. Sodium and ionized calcium displayed overall linear trends with a significant negative bias.</p><p><strong>Conclusions: </strong>Hemolysis can falsely increase or decrease certain blood gas analytes and lead to misinterpretation of results. Therefore, hemolysis detection capabilities are crucial for mitigating this effect and ensuring accurate results for patient care.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Second Opinion: Expert Commentary on \"Persistent Mild Increase of Human Chorionic Gonadotropin in a Male Patient with Testicular Pain\".","authors":"Callie Torres, Ana Villanueva, Ann M Gronowski","doi":"10.1093/jalm/jfae143","DOIUrl":"https://doi.org/10.1093/jalm/jfae143","url":null,"abstract":"<p><p>Elevated human chorionic gonadotropin (hCG) of unknown etiology is often a diagnostic dilemma. Determination of its source is vital in order to provide proper medical treatment and prevent possible unneeded therapeutic interventions. The differential diagnosis for elevated hCG is broad and includes pregnancy, chronic kidney disease, heterophile antibody, macro-hCG, exogenous hCG administration, pituitary secretion, tumor-associated secretion, etc. One entity that is emerging in the published literature as a cause of elevated hCG is familial hCG syndrome. This syndrome is characterized by persistently elevated concentrations from a yet to be determined source in individuals of the same family. In this special report, we review a recently published case of elevated hCG in a 56-year-old male proposed to be due to familial hCG syndrome. We discuss why we feel the presented case is not consistent with familial hCG syndrome and explore other possible explanations for the patient's elevated hCG concentrations.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Clinical Significance of the MCM6 c.-14011C/T Polymorphism in Lactose Intolerance: Insights from a Case Series.","authors":"Stine B Bruun, Jonna S Madsen, Pernille M Bøttger","doi":"10.1093/jalm/jfae138","DOIUrl":"https://doi.org/10.1093/jalm/jfae138","url":null,"abstract":"","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordant Point-of-Care and Laboratory Hemoglobin A1c Concentrations in Ambulatory Settings.","authors":"Nichole Korpi-Steiner, Steven W Cotten, Randie R Little, Deepa Kirk","doi":"10.1093/jalm/jfae153","DOIUrl":"https://doi.org/10.1093/jalm/jfae153","url":null,"abstract":"","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-HDL Cholesterol May Be Preferred over Apolipoprotein B-100 for Risk Assessment when Evaluated by Receiver Operator Characteristic Curve Analysis.","authors":"Stanley S Levinson","doi":"10.1093/jalm/jfae125","DOIUrl":"https://doi.org/10.1093/jalm/jfae125","url":null,"abstract":"<p><strong>Background: </strong>Most studies found that apolipoprotein B (apo B)-100 is a superior marker for coronary risk to non-high-density lipoprotein (HDL) cholesterol (C). Usually, studies use multivariant analysis with single-point odds/risk ratios. In multivariant analysis, when variables are highly correlated they are difficult to interpret. Effects cannot be well discriminated.</p><p><strong>Methods: </strong>Brief review and examination of diagnostic sensitivity and specificity by receiver operator characteristic (ROC) curves at decision levels so that discrimination can be well compared. Since apo B has additional expense, clinical value should be compared in an appropriate format. Apo B and cholesterols were measured in 382 angiographically defined patients.</p><p><strong>Results: </strong>Non-HDLC and apo B were stronger markers than low-density lipoprotein (LDL)C, when examined by logistic regression, but as a result of strong collinearity, non-HDLC appeared weaker than LDLC in the presence of apo B, based on P values. This was true when analyzed with and without nonlipid risk factors. On ROC analysis, apo B and non-HDLC showed stronger C statistics than LDLC and total C. When analyzed alone apo B showed about 6.1% greater sensitivity than non-HDLC. After adjustment for nonlipid risk factors, the C statistics for apo B and non-HDLC were 0.74 and 0.73, and there was little difference in diagnostic specificity.</p><p><strong>Conclusions: </strong>Risk is calculated from an algorithm that includes nonlipid risk factors similar to those examined here along with cholesterols. When assessed by the 10-year screening algorithm, these data support the view that non-HDLC would be less expensive than apo B with similar clinical efficacy.</p>","PeriodicalId":46361,"journal":{"name":"Journal of Applied Laboratory Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}