Annals of Clinical Biochemistry最新文献

{"title":"Response to the letter to the editor by Drs Burmeister and Zazay regarding \"NT-proBNP and its correlation with left ventricular ejection fraction and heart failure: The DEMONSTRATE database.","authors":"Anders Larsson","doi":"10.1177/00045632261456520","DOIUrl":"https://doi.org/10.1177/00045632261456520","url":null,"abstract":"","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261456520"},"PeriodicalIF":1.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UK recommendations for the validation and adoption of capillary blood testing within the routine clinical laboratory: Consensus opinion from the LabMed patient-centred testing and sampling (PaCTS) group.","authors":"Timothy Woolley, Sophie Hepburn, Karen Perkins","doi":"10.1177/00045632261454300","DOIUrl":"https://doi.org/10.1177/00045632261454300","url":null,"abstract":"<p><p>Venepuncture is traditionally regarded as the gold standard for collecting blood samples. However, self-collected capillary blood sampling has emerged as a practical alternative in various settings, fostering a more patient-centred, personalised, and cost-effective healthcare model. The NHS UK strategic plans published in 2023-2025 emphasise a shift in care from hospitals to community settings and from treating illness to preventing it. Self-collected capillary sampling with back-to-laboratory analysis is a strong option to support the shift of healthcare provision into the community while maintaining high-quality results and direct delivery to the electronic patient record.Routine clinical laboratories, particularly those within the NHS, should consider this potential delivery model. However, most assay manufacturers do not currently include capillary blood in their instructions for use. Consequently, UK Accreditation Service-accredited laboratories that wish to conduct routine tests using capillary blood must perform additional comparison studies to obtain accreditation. If this is not done, they must be able to distinguish between non-accredited (capillary blood) and accredited (venous blood) tests.This document has been created to guide clinical laboratorians through the rapidly evolving field of patient-centric sampling and how to enable safe working within a routine clinical laboratory.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454300"},"PeriodicalIF":1.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NT-proBNP and left ventricular ejection fraction correlation: Methodological considerations and clinical heterogeneity.","authors":"James R Burmeister, Ismail Zazay","doi":"10.1177/00045632261454830","DOIUrl":"https://doi.org/10.1177/00045632261454830","url":null,"abstract":"","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454830"},"PeriodicalIF":1.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphate enemas causing profound refractory hypocalcaemia: A case report.","authors":"Jennifer Nobes, Michael J Murphy","doi":"10.1177/00045632261453318","DOIUrl":"https://doi.org/10.1177/00045632261453318","url":null,"abstract":"<p><p>A 37-year-old woman attended hospital with melaena and coffee-ground vomiting on a background of alcohol-related liver disease (ALD). Following upper gastro-intestinal (GI) endoscopy she was admitted to the medical high dependency unit and commenced on multiple medications, in accordance with the decompensated cirrhosis care bundle of the British Association for the Study of the Liver (BASL).¹ The patient was severely encephalopathic, prompting the addition of regular enemas to minimise colonic nitrogen production. On Day 4 post admission, the patient was noted to be hypocalcaemic (adjusted calcium 1.62 mmol/L) and intravenous calcium gluconate was prescribed. By Day 5, adjusted calcium had fallen to a nadir of 0.85 mmol/L; phosphate was 6.4 mmol/L. The rapidly developing inverse relation between calcium and phosphate strongly suggested a causal association. Since Day 3 the patient had received enemas three times daily for severe hepatic encephalopathy. We postulated that rectal absorption of phosphate in the enemas was occurring, contrary to the intended mechanism of action, and recommended they were stopped. Following discontinuation of the phosphate enemas, serum phosphate fell to within the reference range over 72 h. In total, over 70 mmol of calcium (infused as 280 mL of 10% calcium gluconate over a period of 5 days) was required to replace the sequestered calcium. By Day 11, calcium, phosphate and sodium were all within their respective reference ranges.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261453318"},"PeriodicalIF":1.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical performance of a urine albumin-to-creatinine ratio (ACR) strip test compared with quantitative measurement.","authors":"Artur Gabrysiak, Daria Służałek, Karolina Żuradzka, Weronika Michalska-Witas, Sylwia Studnicka, Przemysław Dudek","doi":"10.1177/00045632261456522","DOIUrl":"10.1177/00045632261456522","url":null,"abstract":"<p><p>BackgroundAlbuminuria is an early marker of kidney damage and an essential component of chronic kidney disease (CKD) risk stratification. Quantitative measurement of the urine albumin-to-creatinine ratio (ACR) in a spot, preferably morning, urine sample is the recommended standard. In low-throughput laboratories and point-of-care settings, semi-quantitative strip tests are sometimes used for screening, although their diagnostic performance is limited.ObjectiveTo evaluate the clinical utility of a commercial semi-quantitative urine strip test for albumin and creatinine by comparison with quantitative ACR measurement.MethodsEighty-four spot urine samples were analysed. Semi-quantitative ACR categories were obtained using an ACON Mission strip test, according to the manufacturer's instructions. Quantitative ACR was measured on a Beckman Coulter AU480 analyser (immunochemical albumin, enzymatic creatinine). Diagnostic performance was assessed using sensitivity, specificity, positive and negative predictive values, Matthew's correlation coefficient (MCC) and Cohen's κ. A decision threshold of 3 mg/mmol (30 mg/g) was applied.ResultsSensitivity for detecting albuminuria (≥3 mg/mmol, ≥30 mg/g) was 80.6% (95% CI 62.5-92.5) and specificity was 60.4% (95% CI 46.0-73.5). The negative and positive predictive values were 84.2% and 54.3%, respectively. Overall categorical agreement across A1-A3 was 63.1% (κ = 0.334; MCC = 0.398). Most discrepancies reflected overclassification of low-grade albuminuria by the strip test in samples classified as normoalbuminuric by quantitative ACR.ConclusionsThe semi-quantitative strip test shows high sensitivity with moderate specificity and is suitable for screening for albuminuria. Positive results should be confirmed by quantitative ACR measurement in accordance with current guidelines.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261456522"},"PeriodicalIF":1.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of serum protein and immunofixation electrophoresis images by computer vision-based deep learning models: A single- and dual-modality study.","authors":"Maide Hacer Alagöz, Simge Erdem, Poyraz Doğan, İbrahim Utku Derman, Mehmet Güven Günver, Özlem Çakır Madenci, Evin Ademoğlu","doi":"10.1177/00045632261454299","DOIUrl":"10.1177/00045632261454299","url":null,"abstract":"<p><p>ObjectivesThe objective of this study was to develop deep learning models for the automated classification of serum protein electrophoresis (SPE) and immunofixation electrophoresis (IFE) images into oncologic, non-oncologic, and healthy categories, and to compare the predictive performance of single- and dual-modality approaches.MethodsWe retrospectively collected SPE and IFE images from 1,919 patients who underwent both tests at Kartal Dr Lütfi Kırdar City Hospital. MobileNetV2-based models were developed using transfer learning. Single-modality (SPE or IFE) and dual-modality (SPE and IFE) models were trained, and their performance was evaluated using accuracy, precision, recall, specificity, F1-score, and ROC-AUC. Grad-CAM visualizations were generated to assess model interpretability.ResultsThe dual-modality model achieved higher accuracy and robustness compared to single-modality models. Oncologic cases were detected with near-perfect recall and ROC-AUC, while single-modality models demonstrated moderate performance in distinguishing non-oncologic and healthy groups. Grad-CAM outputs confirmed that the models focused on diagnostically relevant electrophoretic bands.ConclusionDeep learning models can reliably classify electrophoresis images into oncologic, non-oncologic, and healthy categories. Combining SPE and IFE improves diagnostic performance and may assist laboratory specialists and hematologists in reducing subjectivity, particularly in borderline cases. Validation in larger, multicenter cohorts is warranted prior to clinical implementation.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454299"},"PeriodicalIF":1.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, attitudes, and perceived barriers to artificial intelligence adoption in Turkish clinical biochemistry laboratories: An exploratory cross-sectional survey.","authors":"Said İncir, Kerim Erhan Palaoğlu, Osman Oğuz, Ayşegül Özgenç, Yunus Gören, Deniz İlhan Topcu, Dildar Konukoğlu","doi":"10.1177/00045632261454308","DOIUrl":"10.1177/00045632261454308","url":null,"abstract":"<p><p>BackgroundArtificial intelligence (AI) is increasingly recognized as transformative in laboratory medicine, yet adoption lags behind radiology and cardiology. Limited data exist on AI-related attitudes and perceived barriers in Turkish clinical laboratories. This study evaluated professional awareness, attitudes, and perceived barriers to AI adoption among Turkish clinical laboratory professionals.MethodsA cross-sectional survey was conducted among Turkish clinical biochemistry staff between May and June 2025. The 30-item questionnaire covered demographics, AI knowledge, training, current use, future perspectives, and ethical or legal concerns. In total, 170 eligible participants, including laboratory directors, physicians, residents, and technologists, completed the survey.ResultsAmong the participants, 43% self-rated their AI knowledge as \"basic,\" with no participant aged ≥60 years reporting good or expert-level knowledge. The greatest knowledge deficits were in image processing (49.4% reported \"no knowledge\") and predictive analytics (35.9%). More than half (57.6%) had never received AI-related training, and current use of AI tools in routine practice was minimal. Despite these gaps, attitudes toward AI implementation were overwhelmingly positive, with 75.3% believing increased AI use would improve job satisfaction and 59.4% expecting laboratory transition to AI-supported systems within 5 years. Major barriers included insufficient digital infrastructure (47%), absence of trained personnel (83.5%), lack of standard operating procedures (70%), and inadequate legal/ethical regulations (52.9%).ConclusionsAI implementation in Turkish clinical laboratories remains at an early stage but is met with strong professional interest. Overcoming structural barriers through standardized education, infrastructure investment, and clear legal frameworks is essential for sustainable AI implementation in clinical laboratories.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454308"},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance validation and clinical utility of a smartphone-based colorimetric system for differentiating exudative and transudative pleural effusions and ascites via total protein quantification.","authors":"Dandan Liang, Yonghua Zhao, Yufei Guo, Ziqi Li, Zehua Yang","doi":"10.1177/00045632261454287","DOIUrl":"10.1177/00045632261454287","url":null,"abstract":"<p><p>BackgroundTotal protein (TP) is a key indicator to differentiate between pleural effusion (PE) and ascites as exudate or transudate. Rapid quantification of TP can provide more accurate clinical treatment.ObjectiveThis study developed a smartphone-based colorimetric method for the rapid quantification of TP in PE and ascites by measuring the RGB values of reaction products and establishing a correlation between these values and TP concentration.MethodsThe smartphone colorimetric system was validated according to Clinical and Laboratory Standards Institute (CLSI) guidelines, assessing precision, accuracy, detection limit, linearity, and clinical reportable range. To evaluate clinical applicability, we compared results from 43 clinical samples (12 ascites and 31 PE specimens) obtained using the smartphone system with those from an automated biochemical analyzer.ResultsThe G value showed the strongest correlation with TP concentration and was used to generate the standard curve. Validation studies confirmed that the smartphone system's precision and accuracy met clinical requirements, with analytical performance parameters including a limit of blank (3.36 g/L), limit of detection (8.94 g/L), and limit of quantification (13.09 g/L). The method demonstrated good linearity (15.8-93.7 g/L) and a wide clinical reportable range (13.09-374.8 g/L). Deming regression showed excellent agreement with no significant bias. The smartphone-based method and biochemical analyzer achieved near-perfect concordance in differentiating exudative and transudative fluids (PE κ = 0.92, ascites κ = 1.00).ConclusionThe smartphone-based colorimetric system provides a clinically viable solution for the rapid and quantitative measurement of TP in PE and ascites.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454287"},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of urinalysis in two different preservative tubes: A comparative analysis.","authors":"Nilüfer Bayraktar, Eren Vurgun, Seyyide Nur Savran, Fatih Yeşildal","doi":"10.1177/00045632261454297","DOIUrl":"10.1177/00045632261454297","url":null,"abstract":"<p><p>BackgroundSample stability represents a major challenge in the preanalytical phase of urinalysis. This study aimed to evaluate and compare the stability of urine samples stored at room temperature for up to 72 h in two commercially available chlorhexidine-based preservative tubes.MethodsThe study included 44 pathological urine samples. Urinalysis was performed after storage in BD Vacutainer® and Vacusera® tubes at 4, 8, 24, 48, and 72 h. These results were compared with those obtained from refrigerated, non-additive polystyrene (PS) tubes at 0, 4, and 8 h. A level of ≥90% agreement or a kappa value (κ) of ≥0.8 was deemed to represent perfect agreement and stability.ResultsSpecific gravity, pH, glucose, bilirubin, urobilinogen and nitrite were stable in all tubes and conditions. Within the first 4 h, instability was detected in protein in the non-additive PS tube, in ketone and red blood cells (RBC) in the BD tube, and in white blood cells (WBC) in all tubes. By the 8-h mark, ketone and RBC in the non-additive PS tube, as well as bacteria count in the BD tube, failed to maintain stability. Notably, blood and leukocyte esterase remained stable for at least 8 h across all tubes.ConclusionsStorage of urine samples in chlorhexidine-based preservative tubes has minimal impact on urinalysis; however, inter-manufacturer variability exists. To ensure reliable results, analysis should be performed within 4-8 h of collection.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454297"},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference intervals for kidney tubular secretion markers in the general population: The HUNT3 study.","authors":"Marius A Øvrehus, Kåre A Kristiansen, Knut Ar Langlo, Pranav S Garimella, Joachim H Ix, Michael G Shlipak, Per Bruheim, Stein I Hallan","doi":"10.1177/00045632261454284","DOIUrl":"10.1177/00045632261454284","url":null,"abstract":"<p><p>BackgroundChronic kidney disease (CKD) prevalence and prognosis are currently based exclusively on glomerular functions, but the kidney tubule possesses numerous additional functions with pathophysiological and prognostic value. Tubular secretion is also critical for toxin and drug elimination but has not been well described in healthy individuals and corresponding reference ranges have not been established.Material and methodsAmong participants from the Norwegian population-based HUNT3 study we identified a healthy subset by excluding those reporting poor general health, or smoking, diabetes, cardiovascular disease, treated hypertension, severe, and CKD (eGFR <60 mL/min/1.73 m²). We measured 12 well-characterized markers of tubular secretion in blood and urine using liquid chromatography mass spectrometry (LC-MS). Tubular secretory function was reported for each marker as urine/plasma-ratio (UPR, with and without indexing to urine creatinine and osmolality), clearance, and fractional excretion.ResultsWe included 636 healthy participants (295 men) with mean age 47 years (SD 14). Less than 3.2% of participants in age and sex subgroups fell outside the upper and lower limits of a common reference interval, so partitioning for age and sex was not necessary. Median urine/plasma ratio indexed for creatinine (UPRcreat) ranged from 3 to 87 uM/uM·mmol, and plasma clearance ranged from 35 to 976 mL/min. Phenylacetylglutamine, isovalerylglycine, 2-methylsuccinic acid, and hippuric acid demonstrated the highest UPRcreat values (87, 75, 72, and 61 uM/uM·mmol, respectively). We also measured 1,7-dimethyluric acid, kynurenic acid, adipic acid, suberic acid, cinnamoylglycine, 1,2,7-trimethyluric acid, indoxyl sulfate, and p-cresol sulfate. Reference intervals based on 2.5th and 97.5th percentiles were similar across age and sex.ConclusionThis study quantifies reference ranges of endogenous tubular secretory solutes among a population of community dwelling healthy adults.</p>","PeriodicalId":8005,"journal":{"name":"Annals of Clinical Biochemistry","volume":" ","pages":"45632261454284"},"PeriodicalIF":1.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}