Comparability of five analytical systems for the determination of triiodothyronine, thyroxine and thyroid-stimulating hormone
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Qi Zhou
Abstract
Background: The purpose of an external quality assessment (EQA) is to evaluate the analytical capability of clinical laboratories, identify differences among the laboratories and improve analytical quality. Our EQA results show that the rates of unsatisfactory performance for thyroid hormone tests were the highest in all of our EQA programs. Therefore, the main purpose of this study was to investigate unsatisfactory results by comparing the analytical values of five routinely used analytical systems.
Methods: The Kruskal-Wallis and two-sample Kolmogorov-Smirnov tests were used to identify analytical differences among and between analytical systems, respectively.
Results: The rates of significantly different results compared to the total number of analytical results were 81.1%, 64.5%, 93.3%, 50.0% and 56.7% for free triiodothyronine, total triiodothyronine, free thyroxine, total thyroxine and thyroid-stimulating hormone, respectively.
Conclusions: Relatively large analytical differences between analytical systems were observed, especially when the analytical systems were used to measure free thyroid hormones.
Clin Chem Lab Med 2006;44:1363–6.
References
1. Bernal J, Nunez J. Thyroid hormones and brain development. Vitam Horm 2005; 71:95–122.10.1016/S0083-6729(05)71004-9Search in Google Scholar
2. Konig S, Moura NV. Thyroid hormone actions on neural cells. Cell Mol Neurobiol 2002; 22:517–44.10.1023/A:1021828218454Search in Google Scholar
3. Bartalena L, Bogazzi F, Pinchera A. Thyroid function tests and diagnostic protocols for investigation of thyroid dysfunction. Ann Ist Super Sanita 1991; 27:531–9.Search in Google Scholar
4. Uchimura H. Thyroid function tests. Rinsho Byori 2001; 49:319–24.Search in Google Scholar
5. Shahangian S. Proficiency testing in laboratory medicine: uses and limitations. Arch Pathol Lab Med 1998; 122:15–30.Search in Google Scholar
6. Robert WN. Do proficiency testing participants learn from their mistakes? Arch Pathol Lab Med 2002; 126:147–9.10.5858/2002-126-0147-DPTPLFSearch in Google Scholar
7. Johnson PR. The contribution of proficiency testing to improving laboratory performance and ensuring quality patient care. Clin Leadersh Manag Rev 2004; 18:335–41.Search in Google Scholar
8. Pett MA. Nonparametric statistics for health care research. Statistics for small samples and unusual distributions. London: SAGE Publications, 1997:87–93.10.2307/2669654Search in Google Scholar
9. Demers LM, Spencer CA. Laboratory support for the diagnosis and monitoring of thyroid disease. Natl Acad Clin Biochem 2003; 263:1529 [http://www.nacb.org/lmpg/thyroid_lmpg_word.stm].Search in Google Scholar
10. Sadler WA, Murray LM, Turner JG. What does “functional sensitivity” mean? Clin Chem 1996; 42:2051–2.10.1093/clinchem/42.12.2051Search in Google Scholar
11. Price A, Burgin C, Catch I, Cruise M. Functional sensitivity and recovery of thyroid-stimulating hormone [letter]. Clin Chem 2000; 47:2067.10.1093/clinchem/47.11.2067Search in Google Scholar
12. Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyrotropin assays. Clin Chem 1996; 42:140–5.10.1093/clinchem/42.1.140Search in Google Scholar
13. Gonzalez RR, Robaina R, Rodriguez ME, Blanca S. An enzyme immunoassay for determining total thyroxine in human serum using an ultramicroanalytical system. Clin Chim Acta 1991; 197:159–70.10.1016/0009-8981(91)90137-2Search in Google Scholar
14. Papkovskii DB, Savitakill AP, Bykhovskii VI. Fluorescent immunoassay of thyroxine in blood serum. Probl Endo-krinol (Mosk) 1988; 34:58–62.Search in Google Scholar
15. Chen CK, Tsai KS. Clinical application of chemiluminescent immunoassay for thyroid stimulating hormone, free-T4 and intact-parathyroid hormone. J Formos Med Assoc 1996; 95:197–202.Search in Google Scholar
16. Nelson JC, Wilcox RB. Analytical performance of free and total thyroxine assays. Clin Chem 1996; 42:146–54.10.1093/clinchem/42.1.146Search in Google Scholar
17. Soldin SJ, Papanastasiou-Diamandis A, Heyes J, Lingwood C, Olley P. Are immunoassays for digoxin reliable? Clin Biochem 1984; 17:317–20.10.1016/S0009-9120(84)90637-4Search in Google Scholar
18. Soukhova N, Soldin OP, Soldin SJ. Isotope dilution tandem mass spectrometric method for T4/T3. Clin Chim Acta 2004; 343:185–90.10.1016/j.cccn.2004.01.007Search in Google Scholar
19. Miller JJ, Valdes R Jr. Approaches to minimizing interference by cross-reacting molecules in immunoassays. Clin Chem 1991; 37:144–53.10.1093/clinchem/37.2.144Search in Google Scholar
20. Despres N, Grant AM. Antibody interference in thyroid assays: a potential for clinical misinformation. Clin Chem 1998; 44:440–54.10.1093/clinchem/44.3.440Search in Google Scholar
21. Weber TH, Kapyaho KI, Tanner P. Endogenous interference in immunoassays in clinical chemistry [review]. Scand J Clin Lab Invest Suppl 1990; 201:77–82.10.1080/00365519009085803Search in Google Scholar
22. Ritter D, Brown W, Nahm MH, Ladenson JH, Scott MG. Endogenous serum antibodies that interfere with a common thyroid hormone uptake assay: characterization and prevalence. Clin Chem 1994; 40:1940–43.10.1093/clinchem/40.10.1940Search in Google Scholar
23. Levinson SS, Miller JJ. Towards a better understanding of heterophile (and the like) antibody interference with modern immunoassays. Clin Chim Acta 2002; 325:1–15.10.1016/S0009-8981(02)00275-9Search in Google Scholar
24. Klee GG. Interferences in hormone immunoassays. Clin Lab Med 2004; 24:1–18.10.1016/j.cll.2004.01.003Search in Google Scholar
25. Kricka LJ. Human anti-animal antibody interferences in immunological assays. Clin Chem 1999; 45:942–56.10.1093/clinchem/45.7.942Search in Google Scholar
26. Tillman J, Leask JT, Campbell J, Logue FC, Fraser WD. Effect of fenoprofen on thyroid function tests. Clin Chim Acta 1986; 161:233–9.10.1016/0009-8981(86)90216-0Search in Google Scholar
27. Surks MI, DeFesi CR. Normal serum free thyroid hormone concentrations patients treated with phenytoin or carbamazepine. A paradox resolved. J Am Med Assoc 1996; 275:1495–8.10.1001/jama.1996.03530430039036Search in Google Scholar
28. Lucena R, Moreno P, Perez-Rico A, Ginel PJ. Effects of haemolysis, lipaemia and bilirubinaemia on enzyme-linked immunosorbent assay for cortisol and free thyroxine in serum samples from dogs. Vet J 1998; 156:127–31.10.1016/S1090-0233(05)80038-3Search in Google Scholar
29. Parra MD, Bernal LJ, Ceron JJ. Cortisol and free thyroxine determination by time-resolved fluorometry in canine serum. Can J Vet Res 2004; 68:98–104.Search in Google Scholar
30. Wenk RE. Mechanism of interference by hemolysis in immunoassays and requirements for sample quality [letter]. Clin Chem 1998; 44:2554.10.1093/clinchem/44.12.2554Search in Google Scholar
31. Sales V, Miller MA, Libman M. False-positive enzyme immunoassay test results for Chlamydia trachomatis because of contact of the collection swab with agar. Sex Transm Dis 1998; 25:418–20.10.1097/00007435-199809000-00006Search in Google Scholar PubMed
32. Surks MI, Chopra IJ, Mariash CN, Nicoloff JT, Solomon DH. American thyroid association guidelines for use of laboratory tests in thyroid disorders. J Am Med Assoc 1990; 263:1529–32.10.1001/jama.1990.03440110095035Search in Google Scholar
33. Wu AH. Quality specifications in thyroid diseases. Clin Chim Acta 2004; 346:73–7.10.1016/j.cccn.2004.03.020Search in Google Scholar PubMed
34. Soldin SJ, Soukhova N, Janicic N, Jonklass J, Soldin OP. The measurement of free thyroxine by isotope dilution tandem mass spectrometry. Clin Chim Acta 2005; 358:113–8.10.1016/j.cccn.2005.02.010Search in Google Scholar PubMed PubMed Central
©2006 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Renal function – estimation of glomerular filtration rate
- Research translation: a new frontier for clinical laboratories
- Association of APOA5 c.553G>T polymorphism with type 2 diabetes mellitus in a Chinese population
- MTRR 66A>G polymorphism in relation to congenital heart defects
- Increased homocysteine in heart failure: a result of renal impairment?
- Urine flow cytometry and detection of glomerular hematuria
- Chymotrypsin effects on the determination of sperm parameters and seminal biochemistry markers
- Evaluation of cardiac involvement following major orthopedic surgery
- Increased sensitivity in detecting renal impairments by quantitative measurement of marker protein excretion compared to detection of pathological particles in urine sediment analysis
- Clinical chemistry reference values for 75-year-old apparently healthy persons
- Serum pro-hepcidin concentrations and their responses to oral iron supplementation in healthy subjects manifest considerable inter-individual variation
- Comparability of five analytical systems for the determination of triiodothyronine, thyroxine and thyroid-stimulating hormone
- Automated analysis of pleural fluid total and differential leukocyte counts with the Sysmex XE-2100
- Automation and validation of a fast method for the assessment of in vivo oxidative stress levels
- Analytical validation of the new plasma calibrated Accu-Chek® Test Strips (Roche Diagnostics)
- Use of insulin immunoassays in clinical studies involving rapid-acting insulin analogues: Bi-insulin IRMA preliminary assessment
- Analytical and clinical evaluation of a new heart-type fatty acid-binding protein automated assay
- A caveat for OV-Monitor (CA 125 antigen) measurement: something is improving, something is not
- Reply to the letter written by Dorizzi et al.
