Upfront dilution of ferritin samples to reduce hook effect, improve turnaround time and reduce costs
| Autor: | Joshua A Hayden, Shu Juan Wu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030213 general clinical medicine
Serial dilution Clinical Biochemistry Short Communications 030204 cardiovascular system & hematology Turnaround time Toxicology 03 medical and health sciences 0302 clinical medicine Humans Medicine Routine clinical practice turnaround time Retrospective Studies Immunoassay biology business.industry ferritin Biochemistry (medical) immunoassay prozone effect Baseline data Dilution Ferritin Ferritins biology.protein business |
| Zdroj: | Biochemia Medica Volume 28 Issue 1 |
| ISSN: | 1846-7482 1330-0962 |
| DOI: | 10.11613/bm.2018.010903 |
| Popis: | Introduction: Sandwich immunoassays offer advantages in the clinical laboratory but can yield erroneously low results due to hook (prozone) effect, especially with analytes whose concentrations span several orders of magnitude such as ferritin. This study investigated a new approach to reduce the likelihood of hook effect in ferritin immunoassays by performing upfront, five-fold dilutions of all samples for ferritin analysis. The impact of this change on turnaround time and costs were also investigated. Materials and methods: Ferritin concentrations were analysed in routine clinical practice with and without upfront dilutions on Siemens Centaur® XP (Siemens Healthineers, Erlang, Germany) immunoanalysers. In addition, one month of baseline data (1026 results) were collected prior to implementing upfront dilutions and one month of data (1033 results) were collected after implementation. Results: Without upfront dilutions, hook effect was observed in samples with ferritin concentrations as low as 86,028 μg/L. With upfront dilutions, samples with ferritin concentrations as high as 126,050 μg/L yielded values greater than the measurement interval and would have been diluted until an accurate value was obtained. The implementation of upfront dilution of ferritin samples led to a decrease in turnaround time from a median of 2 hours and 3 minutes to 1 hour and 18 minutes (P = 0.002). Conclusions: Implementation of upfront dilutions of all ferritin samples reduced the possibility of hook effect, improved turnaround time and saved the cost of performing additional dilutions. |
| Databáze: | OpenAIRE |
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