Investigation of the dual cascade algorithm in the diagnosis of antinuclear antibodies
| Autor: | Vildan Turan Faraşat, Tamer Sanlidag, Pınar Erbay Dündar, Yavuz Doğan, Gülfem Terek Ece, Talat Ecemiş, Aslı Gamze Şener |
|---|---|
| Přispěvatelé: | Manisa Celal Bayar University, Faculty of Medicine, Department of Medical Microbiology, Manisa, Turkey, Dokuz Eylül University, Faculty of Medicine, Medical Microbiology, Izmir, Turkey, Katip Çelebi University, Faculty of Medicine, Medical Microbiology, Izmir, Turkey, Izmir Medicalpark Hospital, Medical Microbiology, Izmir, Turkey, Manisa Celal Bayar University, Faculty of Medicine, Public Health, Manisa, Turkey, Near East University Research Center of Experimental Health Sciences, Nicosia, Cyprus |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
030203 arthritis & rheumatology
0301 basic medicine Pathology medicine.medical_specialty Anti-nuclear antibody business.industry Biochemistry (medical) Clinical Biochemistry Cascade algorithm DUAL (cognitive architecture) 03 medical and health sciences 030104 developmental biology 0302 clinical medicine medicine Discrete Mathematics and Combinatorics business |
| Popis: | BackgroundThe dual cascade algorithm which involves screening and confirmation of antinuclear antibodies (ANAs) by further reflex testing is widely used in the detection of ANAs. We aimed to investigate this algorithm which is commonly used in many laboratories.MethodsA total of 475 sera obtained from patients with a clinical suspicion of systemic autoimmune rheumatic diseases (SARDs) upon which three expert assessors agreed for interpretation in the indirect immunofluorescence (IIF) test were determined and tested by the line immunoassay (LIA) containing 16 antigens. The results of the tests were statistically compared and evaluated.ResultsIn 141 of the sera (29.7%), there was an agreement between ANA-IIF(+) and LIA(+) results. The overall agreement rate between the two tests for positivity and negativity only was 85.5% with a Cohen’s κ coefficient of 0.69. In 118 of these 141 sera (83.7%), pattern and associated ANA agreement was detected with an overall agreement rate of 80.6% and a Cohen’s κ coefficient of 0.57. The highest agreement between the pattern and associated ANAs was seen in centromere, dense fine speckled (DFS) and cytoplasmic reticular patterns. In these patterns, the rate of anti-centromere-associated protein B (CENP-B), anti-DFS and anti-antimitochondrial antibody M2 (anti-AMA-M2) antibodies were 93.4%, 92.3% and 66.7%, respectively.ConclusionsWe found an overall moderate agreement between IIF screening and LIA confirmation tests. However, the level of agreement varies according to the pattern type. The discrepancy in agreement rates may cause false reflex test requests. Our results highlight the need for collaboration between clinical and laboratory professionals in selected cases instead of the reflex testing approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|