Evaluation of a mobile clinical pathology laboratory developed for the home care of pediatric patients following transplantation of peripheral blood precursor cells
-
Fabio Facco
Abstract
Background: A mobile clinical pathology laboratory (MoLab) was designed, outfitted and evaluated to improve the turnaround time (TAT) of laboratory tests performed in patients who receive follow-up care at home.
Methods: Full blood counts (FBCs), basic clinical biochemistry tests on blood and urine, and basic coagulation and blood gases were measured using bench-top laboratory analyzers to perform point-of-care tests in a mobile setting. The quality of the results was evaluated on the instruments both while the vehicle was at rest and following movement during the course of routine activity.
Results: The equivalence of the values produced by the point-of-care testing (POCT) and central laboratory (CL) measurement procedures was demonstrated and remained stable after movement in city traffic. The TATs ranged from a few minutes for FBCs to <20 min for extended clinical biochemistry tests.
Conclusions: During the first 6 months of activity, the MoLab assured the provision of laboratory results for home care patients in a matter of minutes. This approach not only allowed for real-time modifications in therapy but also reduced the number of second visits by the home care medical team. Point-of-care tests performed on the MoLab were significantly more expensive than the same tests performed in the CL. However, the savings in patient hospitalization expenses and the reduced costs resulting from fewer second daily visits completely offset the costs of using the MoLab during the first 6-month pilot phase.
This work was possible thanks to the valuable support provided by ASCOLL (Savona, Italy) and by the Special Project 5×1000 of Ministero della Salute (Italy).
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
References
1. Miano M, Manfredini L, Garaventa A, Fieramosca S, Tanasini R, Leimer M, etal. Feasibility of a home care program in a pediatric hematology and oncology department. Results of the first year of activity at a single Institution. Haematologica 2002;87:637–42.Search in Google Scholar
2. Miano M, Manfredini L, Garaventa A, Fieramosca S, Tanasini R, Morreale G, etal. Home care for children following haematopoietic stem cell transplantation. Bone Marrow Transplant 2003;31:607–10.10.1038/sj.bmt.1703892Search in Google Scholar PubMed
3. Savio C, Garaventa A, Gremmo M, Camoriano R, Manfredini L, Fieramosca S, etal. Feasibility of integrated home/hospital physiotherapeutic support for children with cancer. Support Care Cancer 2007;15:101–4.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000243399300013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1007/s00520-006-0118-6Search in Google Scholar PubMed
4. Lomonaco T. Proposal of a mobile laboratory suitable for adoption for respiratory functional and cardiocirculatory evaluation of personnel of the Armed Forces. Minerva Med 1958;49:3005–8 (in Italian).Search in Google Scholar PubMed
5. Doos WG, du Moulin GC, Jordi H, Orf HW, Seder R, Skea W, etal. Field tests on four state-of-the-art blood chemistry analyzers in a mobile laboratory setting. Mil Med 1988;153:81–6.10.1093/milmed/153.2.81Search in Google Scholar
6. Langfeldt N, Werth D. Experiences with a mobile laboratory during Operation ‘Kurdenhilfe’ in Iran in 1991. Berl Munch Tierarztl Wochenschr 1993;106:300–2.Search in Google Scholar
7. Grolla A, Jones SM, Fernando L, Strong JE, Stroher U, Moller P, etal. The use of a mobile laboratory unit in support of patient management and epidemiological surveillance during the 2005 Marburg Outbreak in Angola. PLoS Negl Trop Dis 2011;5:e1183.10.1371/journal.pntd.0001183http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000291099100044&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed PubMed Central
8. Liang TS, Erbelding E, Jacob CA, Wicker H, Christmyer C, Brunson S, etal. Rapid HIV testing of clients of a mobile STD/HIV clinic. AIDS Patient Care STDS 2005;19:253–7.10.1089/apc.2005.19.253Search in Google Scholar PubMed
9. Linnet K. Necessary sample size for method comparison studies based on regression analysis. Clin Chem 1999;45:882–94.10.1093/clinchem/45.6.882Search in Google Scholar PubMed
10. Linnet K. Estimation of the linear relationship between the measurements of two methods with proportional errors. Stat Med 1990;9:1463–73.10.1002/sim.4780091210Search in Google Scholar PubMed
11. Linnet K. Performance of Deming regression analysis in case of misspecified analytical error ratio in method comparison studies. Clin Chem 1998;44:1024–31.10.1093/clinchem/44.5.1024Search in Google Scholar PubMed
©2013 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Letters to the Editors
- Clinical utility of serum tumor markers and cytokines in cervical cancer and neoplasia
- Establishing reference intervals for LDL subfractions in a Korean population using the Lipoprint LDL system
- Measurement imprecision of common urinary biochemical analytes on the Roche Cobas 6000 system
- A comparison between turbidimetric inhibition immunoassay and capillary electrophoresis in glycated hemoglobin (HbA1c) measurement
- Commutability: a peculiar property of calibration and control materials. Definition and evaluation
- Diagnostic sensitivity of a panel of tests to detect monoclonal protein in Korean multiple myeloma patients
- Commutability of proficiency testing (PT): status of the matrix-related bias in general clinical chemistry
- Masthead
- Masthead
- Editorial
- Why specifications for allowable glucose meter errors should include 100% of the data
- Reviews
- ABO blood group: old dogma, new perspectives
- Trace elements and bone health
- Mini Review
- The role of transcription factors in laboratory medicine
- Opinion Papers
- Nobelitis: a common disease among Nobel laureates?
- The syndrome of the “obsessive-compulsory scientist”: a new mental disorder?
- Can current analytical quality performance of UK clinical laboratories support evidence-based guidelines for diabetes and ischaemic heart disease? – A pilot study and a proposal
- Guidelines and Recommendations
- Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA)
- General Clinical Chemistry and Laboratory Medicine
- Red cell indices: differentiation between β-thalassemia trait and iron deficiency anemia and application to sickle cell disease and sickle cell thalassemia
- Problems in determining thalassemia carrier status in a program for prevention and control of severe thalassemia syndromes: a lesson from Thailand
- An enzyme linked immunosorbent assay (ELISA) for the determination of the human haptoglobin phenotype
- Blood loss from laboratory diagnostic tests in children
- Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia
- Evaluation of a mobile clinical pathology laboratory developed for the home care of pediatric patients following transplantation of peripheral blood precursor cells
- Folic acid supplementation does not reduce intracellular homocysteine, and may disturb intracellular one-carbon metabolism
- Influence of spurious hemolysis on blood gas analysis
- Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection
- Reference Values and Biological Variations
- Nationwide multicenter study aimed at the establishment of common reference intervals for standardized clinical laboratory tests in Japan
- Cancer Diagnostics
- Application of BRAF, NRAS, KRAS mutations as markers for the detection of papillary thyroid cancer from FNAB specimens by pyrosequencing analysis
- Comparative evaluation of the My5-FU™ immunoassay and LC-MS/MS in monitoring the 5-fluorouracil plasma levels in cancer patients
Articles in the same Issue
- Letters to the Editors
- Clinical utility of serum tumor markers and cytokines in cervical cancer and neoplasia
- Establishing reference intervals for LDL subfractions in a Korean population using the Lipoprint LDL system
- Measurement imprecision of common urinary biochemical analytes on the Roche Cobas 6000 system
- A comparison between turbidimetric inhibition immunoassay and capillary electrophoresis in glycated hemoglobin (HbA1c) measurement
- Commutability: a peculiar property of calibration and control materials. Definition and evaluation
- Diagnostic sensitivity of a panel of tests to detect monoclonal protein in Korean multiple myeloma patients
- Commutability of proficiency testing (PT): status of the matrix-related bias in general clinical chemistry
- Masthead
- Masthead
- Editorial
- Why specifications for allowable glucose meter errors should include 100% of the data
- Reviews
- ABO blood group: old dogma, new perspectives
- Trace elements and bone health
- Mini Review
- The role of transcription factors in laboratory medicine
- Opinion Papers
- Nobelitis: a common disease among Nobel laureates?
- The syndrome of the “obsessive-compulsory scientist”: a new mental disorder?
- Can current analytical quality performance of UK clinical laboratories support evidence-based guidelines for diabetes and ischaemic heart disease? – A pilot study and a proposal
- Guidelines and Recommendations
- Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA)
- General Clinical Chemistry and Laboratory Medicine
- Red cell indices: differentiation between β-thalassemia trait and iron deficiency anemia and application to sickle cell disease and sickle cell thalassemia
- Problems in determining thalassemia carrier status in a program for prevention and control of severe thalassemia syndromes: a lesson from Thailand
- An enzyme linked immunosorbent assay (ELISA) for the determination of the human haptoglobin phenotype
- Blood loss from laboratory diagnostic tests in children
- Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia
- Evaluation of a mobile clinical pathology laboratory developed for the home care of pediatric patients following transplantation of peripheral blood precursor cells
- Folic acid supplementation does not reduce intracellular homocysteine, and may disturb intracellular one-carbon metabolism
- Influence of spurious hemolysis on blood gas analysis
- Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection
- Reference Values and Biological Variations
- Nationwide multicenter study aimed at the establishment of common reference intervals for standardized clinical laboratory tests in Japan
- Cancer Diagnostics
- Application of BRAF, NRAS, KRAS mutations as markers for the detection of papillary thyroid cancer from FNAB specimens by pyrosequencing analysis
- Comparative evaluation of the My5-FU™ immunoassay and LC-MS/MS in monitoring the 5-fluorouracil plasma levels in cancer patients
