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Accurate Results in the Clinical Laboratory
A Guide to Error Detection and Correction
- 1st Edition - January 22, 2013
- Editors: Amitava Dasgupta, Jorge L. Sepulveda
- Language: English
- Paperback ISBN:9 7 8 - 0 - 1 2 - 8 1 0 0 3 4 - 9
- Hardback ISBN:9 7 8 - 0 - 1 2 - 4 1 5 7 8 3 - 5
- eBook ISBN:9 7 8 - 0 - 1 2 - 4 1 5 8 5 8 - 0
This practical, easy-to-use guide, named to Doody’s Core Titles 2013, addresses interference issues in all laboratory tests, including patient epigenetics, process of specimen co… Read more
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Request a sales quoteThis practical, easy-to-use guide, named to Doody’s Core Titles 2013, addresses interference issues in all laboratory tests, including patient epigenetics, process of specimen collection, enzymes, biomarkers. Clinicians and laboratory scientists can therefore rely on one reference which speaks to both their needs of accurate specimen analysis and optimal patient care.
Erroneous hospital and pathology laboratory results can be confusing and problematic, especially in acute care situations. While some factors creating interference, can be identified in the laboratory, detecting many others is often dependent on clinical details unavailable to the laboratory scientists or pathologists. Therefore, clinicians must become proficient in identifying such erroneous reports, and working with pathologists and laboratory scientists so that they can understand the source of such interferences, correct the results, and then decide what course of action must be followed for proper patient management.
- Named to Doody’s Core Titles 2013, a collection development tool for health sciences libraries of all sizes, by Doody Enterprises
- Practical information for both clinicians and laboratory scientists, presented in the form of tables and charts for easy reference
- Focus on range and sources of interferences rather than details of toxicologic mechanisms which are well covered in toxicology textbooks
- Covers interferences across endocrine, oncology, hematology, immunohistochemistry, immunology, serology, microbiology, and molecular testing
Pathologists, clinical chemists, and toxicologists; practicing clinicians, fellows and residents in pathology, internal medicine, emergency medicine and family practice.
Foreword
Preface
List of Contributors
Chapter 1. Variation, Errors, and Quality in the Clinical Laboratory
Introduction
Errors in the Clinical Laboratory
Quality Improvement in the Clinical Laboratory
Conclusions
References
Chapter 2. Effect of Age, Gender, Diet, Exercise, and Ethnicity on Laboratory Test Results
Introduction
Effects of Age-Related Changes on Clinical Laboratory Test Results
Effects of Gender-Related Changes on Clinical Laboratory Test Results
Effects of Diet on Clinical Laboratory Test Results
Effects of Nutraceuticals on Clinical Laboratory Test Results
Effects of Exercise on Clinical Laboratory Test Results
Effects of Ethnicity/Race on ClinicaL Laboratory Test Results
Conclusions
References
Chapter 3. Effect of Patient Preparation, Specimen Collection, Anticoagulants, and Preservatives on Laboratory Test Results
Introduction
Biological Rhythms and Laboratory Test Results
Issues of Patient Preparation
Differences Between Whole Blood, Plasma, and Serum Specimens for Clinical Laboratory Analysis
Different Anticoagulants and Preservatives, Order of Draw, Problems with Gel Interference in Serum Separator Tubes, and Short Draws
Order of Draw of Various Blood Collection Tubes
Collection Sites; Differences Between Arterial, Capillary, and Venous Blood Samples; and Problems with Collections from Catheters and Intravenous Lines
Urine Collection, Timing, and Techniques
Conclusions
References
Chapter 4. Sample Processing and Specimen Misidentification Issues
Introduction
Transportation
The Effects of Centrifugation on Laboratory Results
Effect of Storage Conditions on Laboratory Results
Effect of Cross-Contamination of Specimens on Laboratory Results
Consequences of Specimen Misidentification on Laboratory Testing
Conclusions
References
Chapter 5. Hemolysis, Lipemia, and High Bilirubin: Effect on Laboratory Tests
Introduction
Effect of Hemolysis on Laboratory Tests
Lipemia
Icterus
Methods for Evaluating the Effect of Endogenous Interfering Substances on Laboratory Tests
Conclusions
References
Chapter 6. Immunoassay Design and Mechanisms of Interferences
Introduction
Immunoassay Methods and Assay Principles
Specimen Types Used in Immunoassays
Examples of Immunoassays
Pitfalls in Immunoassays
How to Detect and Correct Heterophilic Antibody Interferences
Conclusions
References
Chapter 7. Effect of Herbal Remedies on Clinical Laboratory Tests
Introduction
Elevated Liver Function Test Due to Use of Herbal Supplements
Herbal Supplements Causing Kidney Damage
Herbal Remedies and Hypoglycemia
Licorice and Hypokalemia
Kelp and Abnormal Thyroid Function Tests
Drug–Herb Interaction and Unexpected Drug Levels in Routine Drug Monitoring
Adulteration of Herbal Supplements with Western Drugs
Conclusions
References
Chapter 8. Challenges in Routine Clinical Chemistry Testing: Analysis of Small Molecules
Introduction
Creatinine Analysis
Urea Analysis
Ammonia Assay
Uric Acid Analysis
Glucose Analysis
Analysis of Electrolytes
Blood Gases Analysis
Lactate Analysis
Bilirubin Analysis
Lipid Profiles Analysis
Conclusions
References
Chapter 9. Challenges in Routine Clinical Chemistry Analysis: Proteins and Enzymes
Introduction
Albumin and Total Protein
Alanine and Aspartate Aminotransferases Analysis
γ-Glutamyl Transferase and Alkaline Phosphatase Analysis
Amylase and Lipase Analysis
Lactate Dehydrogenase Analysis
Creatine Kinase Analysis
Cardiac Troponin Analysis
B-Type Natriuretic Peptide Analysis
Conclusions
References
Chapter 10. Sources of Inaccuracy in Biochemical Genetics Testing
Introduction
Analysis of Amino ACIDS
Analysis of Organic ACIDS
Analysis of Acylcarnitines
Conclusions
References
Chapter 11. Challenges in Endocrinology Testing
Introduction
Challenges in Testing of Hormones Secreted by Pituitary
Challenges in Measuring Human Chorionic Gonadotropin
Challenges in Thyroid Tumor Marker Tests
Adrenal Function Tests
Testing of Parathyroid Function
Gonadal and Reproductive Interferences
Prostate
Testing for Insulin-Like Growth Factor 1
Measurement of Other Hormones Including Insulin
Prenatal Testing
Conclusions
References
Chapter 12. Pitfalls in Tumor Markers Testing
Introduction
Clinical Uses of Tumor Markers
Prostate-Specific Antigen
CA-125
α-Fetal Protein
Carcinoembryonic Antigen
CA-19-9
β2-Microglobulin
Human Chorionic Gonadotropin
Interference from Heterophilic Antibodies in Laboratory Testing of Tumor Markers
Analysis of Less Frequently Assayed Tumor Markers
Conclusion
References
Chapter 13. Issues of Interferences in Therapeutic Drug Monitoring
Introduction
Sources of Pre-Analytical Interferences in TDM
Sources of Analytical Interferences in TDM
Mechanisms of Analytical Interferences in TDM
Chromatography and Mass Spectrometry
Examples of Interferences that Affect TDM
Conclusions
References
Chapter 14. Limitations of Drugs of Abuse Testing
Introduction
Drugs of Abuse Testing: Medical Versus Legal
Drugs Tested in Drugs of Abuse Testing Protocols
Drug Testing Methodologies
Challenges in Testing for Amphetamines
Challenges in Testing of Cocaine Metabolite
Challenges in Testing for Opiates
Challenges in Testing for Marijuana Metabolites
Challenges in Testing for Phencyclidine
Challenges in Testing for Benzodiazepines
Challenges in Determining Other Drugs by Immunoassays
Adulterants and Drugs of Abuse Testing
Other Drugs not Detected by Routine Toxicology Screens
Conclusions
References
Chapter 15. Challenges in Confirmation Testing for Drugs of Abuse
Introduction: Factors to Consider when Interpreting Drug Testing Results
Confirmation Testing Process
Confirmation of Amphetamines
Confirmation of Cocaine Metabolite Benzoylecgonine
Confirmation of Opiates
Confirmation of Marijuana Metabolite
Confirmation of Phencyclidine
Confirmation of Benzodiazepines
Confirmation of Barbiturates
Specimen Validity Testing
Conclusions
References
Chapter 16. Alcohol Determination Using Automated Analyzers: Limitations and Pitfalls
Introduction
Development of Laboratory Methods for Ethanol Measurement
Current Automated Methodologies
Performance of Automated Ethanol Assays
Problems with Current Methodologies
Strategies for Removing Interferences
Further Case Studies
Future Directions
Conclusions
References
Chapter 17. Pre-Analytical Issues and Interferences in Transfusion Medicine Tests
Introduction
Basics of Immunohematology
Methodology Used for Immunohematology Tests
Pre-Transfusion Evaluation
Interferences in Basic Transfusion Medicine Tests
Case Studies
Conclusions
References
Chapter 18. Issues with Immunology and Serology Testing
Introduction
Challenges in Hemoglobinopathy Detection
Detection of Monoclonal Proteins
Challenges in HIV Testing
Hepatitis Testing
Anti-Nuclear Antibodies
Conclusions
References
Chapter 19. Sources of Errors in Hematology and Coagulation Testing
Introduction
Errors in Hemoglobin Measurement and RBC Count
Errors in MCV and Related Measurements
Errors in WBC Counts and WBC Differential Counts
Errors in Platelet Count
Errors in Specific Hematology Testing
Coagulation Testing
Errors in PT and aPTT Measurements
Errors in Thrombin Time Measurement
Platelet Aggregation Testing with Lipemic, Hemolyzed, or Thrombocytopenic Samples
Challenges in Anticoagulants and Lupus Anticoagulant Tests
Case Studies
Conclusions
References
Chapter 20. Challenges in Clinical Microbiology Testing
Introduction
Issues with Pre-Analytical Errors
Analytical Errors in the Microbiology Laboratory
Post-Analytical or Reporting Errors
Error Prevention, Detection, and Monitoring
Conclusions
References
Chapter 21. Sources of Errors in Molecular Testing
Introduction
Principles of Commonly Used Methods for Molecular Diagnostics
Principles of Nucleic Acid Isolation
Pre-Analytical Considerations in Molecular Testing
Interferences in Molecular Diagnostics: False-Negative Results in Molecular Assays
Interferences in Molecular Testing: False-Positive Test Results in Molecular Assays
Sources of Errors in DNA Microarray Testing
Quality Management
Conclusions
References
Chapter 22. Problems in Pharmacogenomics Testing
Introduction
Method Descriptions
Applications of Pharmacogenetics Testings
Case Studies
Conclusions
References
Index
- No. of pages: 382
- Language: English
- Edition: 1
- Published: January 22, 2013
- Imprint: Elsevier
- Paperback ISBN: 9780128100349
- Hardback ISBN: 9780124157835
- eBook ISBN: 9780124158580
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Amitava Dasgupta
Amitava Dasgupta received his Ph. D in chemistry from Stanford University and completed his fellowship training in Clinical Chemistry from the Department of Laboratory Medicine at the University of Washington School of Medicine at Seattle. He is board certified in both Toxicology and Clinical Chemistry by the American Board of Clinical Chemistry. Currently, he is a tenured Full Professor of Pathology and Laboratory Medicine at the University of Kansas Medical Center and Director of Clinical Laboratories at the University of Kansas Hospital. Prior to this appointment he was a tenured Professor of Pathology and Laboratory Medicine at the University of Texas McGovern medical School from February 1998 to April 2022. He has 252 papers to his credit. He is in the editorial board of four journals including Therapeutic Drug Monitoring, Clinica Chimica Acta, Archives of Pathology and Laboratory Medicine, and Journal of Clinical Laboratory Analysis.
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