Reporting altered test results in hemolyzed samples: is the cure worse than the disease?
-
Giuseppe Lippi
,
Gianfranco Cervellin
Abstract
The management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement. This approach carries some advantages, namely the timely communication of potentially life-threatening laboratory values, but also some drawbacks. These especially include the challenging definition of validated performance specifications for hemolyzed samples, the need to producing reliable data with the lowest possible uncertainty, the short turnaround time for repeating most laboratory tests, the risk that the comments may be overlooked in short-stay and frequently overcrowded units (e.g. the emergency department), as well as the many clinical advantages of a direct communication with the physician in charge of the patient. Despite the debate remains open, we continue supporting the suggestion that suppressing data in unsuitable (hemolyzed) samples and promptly notifying the clinicians about the need to recollect the samples remains the most (clinically and analytically) safe practice.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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- Editorial
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- Reviews
- Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption
- Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis
- Opinion Paper
- Traceability in laboratory medicine: a global driver for accurate results for patient care
- Point
- To report or not to report: a proposal on how to deal with altered test results in hemolytic samples
- Counterpoint
- Reporting altered test results in hemolyzed samples: is the cure worse than the disease?
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- Early mixed hematopoietic chimerism detection by digital droplet PCR in patients undergoing gender-mismatched hematopoietic stem cell transplantation
- Comparison of Abbott RealTime genotype II, GeneMatrix restriction fragment mass polymorphism and Sysmex HISCL HCV Gr assays for hepatitis C virus genotyping
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- Letters to the Editor
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Articles in the same Issue
- Frontmatter
- Editorial
- Biomarkers of acute kidney injury: a step forward
- Reviews
- Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption
- Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis
- Opinion Paper
- Traceability in laboratory medicine: a global driver for accurate results for patient care
- Point
- To report or not to report: a proposal on how to deal with altered test results in hemolytic samples
- Counterpoint
- Reporting altered test results in hemolyzed samples: is the cure worse than the disease?
- Genetics and Molecular Diagnostics
- Early mixed hematopoietic chimerism detection by digital droplet PCR in patients undergoing gender-mismatched hematopoietic stem cell transplantation
- Comparison of Abbott RealTime genotype II, GeneMatrix restriction fragment mass polymorphism and Sysmex HISCL HCV Gr assays for hepatitis C virus genotyping
- General Clinical Chemistry and Laboratory Medicine
- The relationship between vacuum and hemolysis during catheter blood collection: a retrospective analysis of six large cohorts
- Evaluation of the Greiner Bio-One serum separator BCA Fast Clot tube
- Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays
- Parathormone stability in hemodialyzed patients and healthy subjects: comparison on non-centrifuged EDTA and serum samples with second- and third-generation assays
- Association between plasma proANP and hyperuricemia in Chinese Han women: a cross-sectional study
- Activity of the liver enzyme ornithine carbamoyltransferase (OTC) in blood: LC-MS/MS assay for non-invasive diagnosis of ornithine carbamoyltransferase deficiency
- Detecting paraprotein interference on a direct bilirubin assay by reviewing the photometric reaction data
- Prediction of human iron bioavailability using rapid c-ELISAs for human plasma hepcidin
- Reference Values and Biological Variations
- Determination of glucose-6-phosphate dehydrogenase cut-off values in a Tunisian population
- Plasma levels of endothelin-1 and renal function among young and healthy adults
- Cancer Diagnostics
- A new strategy for calculating the risk of ovarian malignancy algorithm (ROMA)
- Laboratory characterization of leukemic cell procoagulants
- Diabetes
- Preparation, calibration and evaluation of the First International Standard for human C-peptide
- Hb variants in Korea: effect on HbA1c using five routine methods
- Letters to the Editor
- Pseudohyperkalemia in capillary whole-blood samples – an occasional error or a significant problem in a pediatric hospital?
- Elevation of creatine kinase is linked to disease severity and predicts fatal outcomes in H7N9 infection
- Analytical evaluation of point-of-care procalcitonin (PCT) and clinical performances in an unselected population as compared with central lab PCT assay
- Evaluation of an automated commercial ELISA method for calprotectin determination in pleural fluid
- The unfinished story of interference in thyroid hormones with Roche immunoassays: when prewashing procedures matter
- Effects of apixaban on prothrombin time, activated partial thromboplastin time and anti-Xa assays: a European survey
- Evaluation of a chemiluminescent immunoassay for urinary aldosterone on the DiaSorin LIAISON automated platform against RIA and LC-MS/MS
- Complex considerations when tendering for HbA1c analysers
