Dataset Information

Lipemia Interferences in Biochemical Tests, Investigating the Efficacy of Different Removal Methods in comparison with Ultracentrifugation as the Gold Standard.

ABSTRACT: Introduction. As a common interferer in clinical chemistry, lipemic specimens could be a source of significant analytical errors. Ultracentrifugation has been by far the only reliable, but an unavailable and expensive, method to eliminate the lipemic effect. Materials and Methods. Among the daily samples, those with triglyceride >400?mg/dL (4.6?mmol/L) and also turbid were selected, divided into three groups, based on triglyceride concentration, and three pooled serums were made for each group. Then all pooled serums were investigated by using a DIRUI biochemistry analyzer CS-800 for routine chemistry tests in different methods including direct measurement, serum blank, serum dilution, and measurement after ultracentrifugation. Results:According to our study, there were significant differences before and after ultracentrifugation in all lipemic levels and for all parameters except for alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, and uric acid. Based on allowable inaccuracy for each parameter, calcium, magnesium, phosphorus, total protein, iron, total iron-binding capacity (TIBC), urea, and chloride are being influenced by all lipemic degree and neither serum dilution nor using serum blank is as effective as ultracentrifuge for elimination. Serum blank was a proper method of lipid removal for the measurement of glucose. Conclusion:Lipemia is a well-known interferer in clinical chemistry. One cannot avoid lipemia, but fortunately, severe lipemia is a rare phenomenon in the laboratory, and for assessment of some analytes in a lower degree of lipemia, use of serum blank eliminates the need for ultracentrifuge.

SUBMITTER: Soleimani N

PROVIDER: S-EPMC7037534 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Lipemia Interferences in Biochemical Tests, Investigating the Efficacy of Different Removal Methods in comparison with Ultracentrifugation as the Gold Standard.

Soleimani Neda N Mohammadzadeh Sahand S Asadian Fateme F

Journal of analytical methods in chemistry 20200212

<i>Introduction</i>. As a common interferer in clinical chemistry, lipemic specimens could be a source of significant analytical errors. Ultracentrifugation has been by far the only reliable, but an unavailable and expensive, method to eliminate the lipemic effect. <i>Materials and Methods</i>. Among the daily samples, those with triglyceride >400 mg/dL (4.6 mmol/L) and also turbid were selected, divided into three groups, based on triglyceride concentration, and three pooled serums were made fo ...[more]

PMID: 32104611

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Project description:ObjectiveThe Bayesian model plays an important role in diagnostic test evaluation in the absence of the gold standard, which used the external prior distribution of a parameter combined with sample data to yield the posterior distribution of the test characteristics. However, the correlation between diagnostic tests has always been a problem that cannot be ignored in the Bayesian model evaluation. This study will discuss how different Bayesian model, correlation scenarios, and prior distribution affect the outcome.MethodsThe data analyzed in this study was gathered during studies of patients presenting to the Nanjing Chest Hospital with suspected tuberculosis. The diagnostic character of T-SPOT.Tb and KD38 tuberculosis antibody test were evaluated in different Bayesian model, and discharge diagnosis as a gold standard was used to verify the model results in the end.ResultThe comparison of four models under the conditional independence situation found that Bayesian probabilistic constraint model was consistent with the Conditional Covariance Bayesian model. The results were mainly affected by prior information. The sensitivity and specificity of the two tests in Conditional Covariance Bayesian model in prior constraint situation were considerably higher than the Bayesian probabilistic constraint model in prior constraint situation. The results of the four models under the conditional dependence situation were similar to the conditional independence situation; pD was also negative with no prior constraint situation in both model Bayesian probabilistic constraint model and Conditional Covariance Bayesian model. The Deviance Information Criterion of Bayesian probabilistic constraint model was close to model Conditional Covariance Bayesian model, but pD of Conditional Covariance Bayesian model in Prior constraint situation (pD=2.40) was higher than the Bayesian probabilistic constraint model in Prior constraint situation (pD=1.66).ConclusionThe result of Conditional Covariance Bayesian model in prior constraint with conditional independence situation was closest to the result of gold standard evaluation in our data. Both of the two Bayesian methods are the feasible way for the evaluation of diagnostic test in the absence of the gold standard diagnostic. Prior source, priority number, and conditional dependencies should be considered in the method selection, the accuracy of posterior estimation mainly depending on the prior distribution.

Project description:ObjectiveTo systematically review methods developed and employed to evaluate the diagnostic accuracy of medical test when there is a missing or no gold standard.Study design and settingsArticles that proposed or applied any methods to evaluate the diagnostic accuracy of medical test(s) in the absence of gold standard were reviewed. The protocol for this review was registered in PROSPERO (CRD42018089349).ResultsIdentified methods were classified into four main groups: methods employed when there is a missing gold standard; correction methods (which make adjustment for an imperfect reference standard with known diagnostic accuracy measures); methods employed to evaluate a medical test using multiple imperfect reference standards; and other methods, like agreement studies, and a mixed group of alternative study designs. Fifty-one statistical methods were identified from the review that were developed to evaluate medical test(s) when the true disease status of some participants is unverified with the gold standard. Seven correction methods were identified and four methods were identified to evaluate medical test(s) using multiple imperfect reference standards. Flow-diagrams were developed to guide the selection of appropriate methods.ConclusionVarious methods have been proposed to evaluate medical test(s) in the absence of a gold standard for some or all participants in a diagnostic accuracy study. These methods depend on the availability of the gold standard, its' application to the participants in the study and the availability of alternative reference standard(s). The clinical application of some of these methods, especially methods developed when there is missing gold standard is however limited. This may be due to the complexity of these methods and/or a disconnection between the fields of expertise of those who develop (e.g. mathematicians) and those who employ the methods (e.g. clinical researchers). This review aims to help close this gap with our classification and guidance tools.

Dataset Information

Lipemia Interferences in Biochemical Tests, Investigating the Efficacy of Different Removal Methods in comparison with Ultracentrifugation as the Gold Standard.

Publications

Lipemia Interferences in Biochemical Tests, Investigating the Efficacy of Different Removal Methods in comparison with Ultracentrifugation as the Gold Standard.

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