Precision, accuracy, cross reactivity and comparability of serum indices measurement on Abbott Architect c8000, Beckman Coulter AU5800 and Roche Cobas 6000 c501 clinical chemistry analyzers
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Nora Nikolac Gabaj
, Marijana Miler
Abstract
Background:
The aim of our study was to perform verification of serum indices on three clinical chemistry platforms.
Methods:
This study was done on three analyzers: Abbott Architect c8000, Beckman Coulter AU5800 (BC) and Roche Cobas 6000 c501. The following analytical specifications were verified: precision (two patient samples), accuracy (sample with the highest concentration of interferent was serially diluted and measured values compared to theoretical values), comparability (120 patients samples) and cross reactivity (samples with increasing concentrations of interferent were divided in two aliquots and remaining interferents were added in each aliquot. Measurements were done before and after adding interferents).
Results:
Best results for precision were obtained for the H index (0.72%–2.08%). Accuracy for the H index was acceptable for Cobas and BC, while on Architect, deviations in the high concentration range were observed (y=0.02 [0.01–0.07]+1.07 [1.06–1.08]x). All three analyzers showed acceptable results in evaluating accuracy of L index and unacceptable results for I index. The H index was comparable between BC and both, Architect (Cohen’s κ [95% CI]=0.795 [0.692–0.898]) and Roche (Cohen’s κ [95% CI]=0.825 [0.729–0.922]), while Roche and Architect were not comparable. The I index was not comparable between all analyzer combinations, while the L index was only comparable between Abbott and BC. Cross reactivity analysis mostly showed that serum indices measurement is affected when a combination of interferences is present.
Conclusions:
There is heterogeneity between analyzers in the hemolysis, icteria, lipemia (HIL) quality performance. Verification of serum indices in routine work is necessary to establish analytical specifications.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
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.
References
1. McCaughey EJ, Vecellio E, Lake R, Li L, Burnett L, Chesher D, et al. Current methods of haemolysis detection and reporting as a source of risk to patient safety: a narrative review. Clin Biochem Rev 2016;37:143–51.Search in Google Scholar
2. Simundic AM, Nikolac N, Ivankovic V, Ferenec-Ruzic D, Magdic B, Kvaternik M, et al. Comparison of visual versus automated detection of lipemic, icteric and hemolyzed specimens: can we rely on a human eye? Clin Chem Lab Med 2009;47:1361–5.10.1515/CCLM.2009.306Search in Google Scholar PubMed
3. Lippi G. Systematic assessment of the hemolysis index: pros and cons. Adv Clin Chem 2015;71:157–70.10.1016/bs.acc.2015.05.002Search in Google Scholar PubMed
4. Farrell CJ, Carter AC. Serum indices: managing assay interference. Ann Clin Biochem 2016;53(Pt 5):527–38.10.1177/0004563216643557Search in Google Scholar PubMed
5. Lippi G, Plebani M. Continuous-flow automation and hemolysis index: a crucial combination. J Lab Autom 2013;18:184–8.10.1177/2211068212450014Search in Google Scholar PubMed
6. Lippi G, Avanzini P, Campioli D, Da Rin G, Dipalo M, Aloe R, et al. Systematical assessment of serum indices does not impair efficiency of clinical chemistry testing: a multicenter study. Clin Biochem 2013;46:1281–4.10.1016/j.clinbiochem.2013.06.007Search in Google Scholar PubMed
7. Clinical and Laboratory Standards Institute (CLSI). Hemolysis, icterus, and lipemia/turbidity indices as indicators of interference in clinical laboratory analysis; approved guideline. CLSI document C56-A. Wayne, PE, USA: Clinical and Laboratory Standards Institute, 2012.Search in Google Scholar
8. Dolci A, Panteghini M. Harmonization of automated hemolysis index assessment and use: is it possible? Clin Chim Acta 2014;432:38–43.10.1016/j.cca.2013.10.012Search in Google Scholar PubMed
9. Topic E, Nikolac N, Panteghini M, Theodorsson E, Salvagno GL, Miler M, et al. How to assess the quality of your analytical method? Clin Chem Lab Med 2015;53:1707–18.10.1515/cclm-2015-0869Search in Google Scholar PubMed
10. Boyd JM, Krause R, Waite G, Hui W, Yazdi E, Wilmink D, et al. Developing optimized automated rule sets for reporting hemolysis, icterus and lipemia based on a priori outcomes analysis. Clin Chim Acta 2015;450:31–8.10.1016/j.cca.2015.07.006Search in Google Scholar PubMed
11. Shin DH, Kim J, Uh Y, Lee SI, Seo DM, Kim KS, et al. Development of an integrated reporting system for verifying hemolysis, icterus, and lipemia in clinical chemistry results. Ann Lab Med 2014;34:307–12.10.3343/alm.2014.34.4.307Search in Google Scholar PubMed PubMed Central
12. Clinical and Laboratory Standards Institute. Evaluation of Precision Performance of Quantitative measurement Methods; Approved Guideline, Second edition; EP5-A2. Wayne, PA, USA: Clinical and Laboratory Standards Institute, 2004.Search in Google Scholar
13. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012;22:276–82.10.11613/BM.2012.031Search in Google Scholar
14. Nikolac N, Celap I, Filipi P, Hemar M, Kocijancic M, Miler M, et al. Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples. Clin Chem Lab Med 2016;54:419–25.10.1515/cclm-2015-0650Search in Google Scholar PubMed
15. Dorotić A, Antončić D, Biljak VR, Nedić D, Beletić A. Hemolysis from a nurses’ standpoint – survey from four Croatian hospitals. Biochem Med (Zagreb) 2015;25:393–400.10.11613/BM.2015.039Search in Google Scholar PubMed PubMed Central
16. Lippi G, Luca Salvagno G, Blanckaert N, Giavarina D, Green S, Kitchen S, et al. Multicenter evaluation of the hemolysis index in automated clinical chemistry systems. Clin Chem Lab Med 2009;47:934–9.10.1515/CCLM.2009.218Search in Google Scholar PubMed
17. Lippi G. Interference studies: focus on blood cell lysates preparation and testing. Clin Lab 2012;58:351–5.Search in Google Scholar
18. Clinical and Laboratory Standards Institute (CLSI). Reference and Selected Procedures for the Quantitative Determination of Hemoglobin in Blood; Approved Standard, Third Edition. CLSI document H15A3. Wayne, PE, USA: Clinical and Laboratory Standards Institute, 2000.Search in Google Scholar
19. Han V, Serrano K, Devine DV. A comparative study of common techniques used to measure haemolysis in stored red cell concentrates. Vox Sang 2010;98:116–23.10.1111/j.1423-0410.2009.01249.xSearch in Google Scholar PubMed
20. Fernandez P, Llopis MA, Perich C, Alsina MJ, Alvarez V, Biosca C, et al. Harmonization in hemolysis detection and prevention. A working group of the Catalonian Health Institute (ICS) experience. Clin Chem Lab Med 2014;52:1557–68.10.1515/cclm-2013-0935Search in Google Scholar PubMed
21. Kroll MH, McCudden CR. Endogenous interferences in clinical laboratory tests. Icteric, lipemic and turbid samples. Berlin/Boston: Walter de Gruyter GmbH, 2013.10.1515/9783110266221Search in Google Scholar
22. Alvarez F, Whalen K, Scott MG. Conjugated, but not unconjugated, bilirubin negatively interferes in Hitachi 747 assay of inorganic phosphorus. Clin Chem USA 1993;39:2345–6.10.1093/clinchem/39.11.2345aSearch in Google Scholar
23. Nikolac Gabaj N, Miler M, Mihic R. I index is not an accurate indicator of icteria in conjugated hyperbilirubinemia. Clin Chim Acta 2017;473:32–4.10.1016/j.cca.2017.08.013Search in Google Scholar PubMed
24. Salinas M, López-Garrigós M, Lugo J, Gutiérrez M, Flors L, Leiva-Salinas C. Diagnostic accuracy of icteric index to detect abnormal total bilirubin values. J Clin Pathol 2012;65: 928–33.10.1136/jclinpath-2012-200811Search in Google Scholar PubMed
25. Nicolay A, Lorec AM, Gomez G, Portugal H. Icteric human samples: icterus index and method of estimating an interference-free value for 16 biochemical analyses. J Clin Lab Anal 2017. doi: 10.1002/jcla.22229. [Epub ahead of print].10.1002/jcla.22229Search in Google Scholar PubMed PubMed Central
26. Nikolac N, Simundic AM, Miksa M, Lima-Oliveira G, Salvagno GL, Caruso B, et al. Heterogeneity of manufacturers’ declarations for lipemia interference – urgent call for standardization. Clin Chim Acta 2013;426:33–40.10.1016/j.cca.2013.08.015Search in Google Scholar PubMed
27. Grunbaum AM, Gilfix BM, Hoffman RS, Lavergne V, Morris M, Miller-Nesbitt A, et al. Review of the effect of intravenous lipid emulsion on laboratory analyses. Clin Toxicol (Phila) 2016;54:92–102.10.3109/15563650.2015.1115515Search in Google Scholar PubMed
28. Nikolac N. Lipemia: causes, interference mechanisms, detection and management. Biochem Med (Zagreb) 2014;24:57–67.10.11613/BM.2014.008Search in Google Scholar PubMed PubMed Central
29. Twomey PJ, Don-Wauchope AC, McCullough D. Unreliability of triglyceride measurement to predict turbidity induced interference. J Clin Pathol 2003;56:861–2.10.1136/jcp.56.11.861Search in Google Scholar PubMed PubMed Central
30. Lippi G, Giavarina D, Gelati M, Salvagno GL. Reference range of hemolysis index in serum and lithium-heparin plasma measured with two analytical platforms in a population of unselected outpatients. Clin Chim Acta 2014;429:143–6.10.1016/j.cca.2013.12.010Search in Google Scholar PubMed
31. Petrova DT, Cocisiu GA, Eberle C, Rhode KH, Brandhorst G, Walson PD, et al. Can the Roche hemolysis index be used for automated determination of cell-free hemoglobin? A comparison to photometric assays. Clin Biochem 2013;46:1298–301.10.1016/j.clinbiochem.2013.06.018Search in Google Scholar PubMed
©2018 Walter de Gruyter GmbH, Berlin/Boston
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- Gender-partitioned patient medians of serum albumin requested by general practitioners for the assessment of analytical stability
- Cancer Diagnostics
- Detection of EGFR, KRAS and BRAF mutations in metastatic cells from cerebrospinal fluid
- Cardiovascular Diseases
- No additional value of conventional and high-sensitivity cardiac troponin over clinical scoring systems in the differential diagnosis of type 1 vs. type 2 myocardial infarction
- Letters to the Editor
- Rare inclusion bodies within monocytes at accelerated phase of Chediak-Higashi syndrome
- A specific abnormal scattergram of peripheral blood leukocytes that may suggest hairy cell leukemia
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Articles in the same Issue
- Frontmatter
- Editorials
- Scientific publishing in the “predatory” era
- The influence of age and other biological variables on the estimation of reference limits of cardiac troponin T
- Reviews
- Prognostic and predictive value of EGFR and EGFR-ligands in blood of breast cancer patients: a systematic review
- GSTP1 methylation in cancer: a liquid biopsy biomarker?
- Opinion Paper
- Practical recommendations for managing hemolyzed samples in clinical chemistry testing
- Genetics and Molecular Diagnostics
- Non-invasive prenatal diagnosis of paternally inherited disorders from maternal plasma: detection of NF1 and CFTR mutations using droplet digital PCR
- Circulating miR-21, miR-210 and miR-146a as potential biomarkers to differentiate acute tubular necrosis from hepatorenal syndrome in patients with liver cirrhosis: a pilot study
- Pleiotropy of ABO gene: correlation of rs644234 with E-selectin and lipid levels
- General Clinical Chemistry and Laboratory Medicine
- Three-year customer satisfaction survey in laboratory medicine in a Chinese university hospital
- Measurement of sirolimus concentrations in human blood using an automated electrochemiluminescence immunoassay (ECLIA): a multicenter evaluation
- Precision, accuracy, cross reactivity and comparability of serum indices measurement on Abbott Architect c8000, Beckman Coulter AU5800 and Roche Cobas 6000 c501 clinical chemistry analyzers
- Commutability of control materials for external quality assessment of serum apolipoprotein A-I measurement
- Development of a new biochip array for APOE4 classification from plasma samples using immunoassay-based methods
- Validation of a high-performance liquid chromatography method for thiopurine S-methyltransferase activity in whole blood using 6-mercaptopurine as substrate
- Increased serum concentrations of soluble ST2 are associated with pulmonary complications and mortality in polytraumatized patients
- Reference Values and Biological Variations
- Determination of age- and sex-specific 99th percentiles for high-sensitive troponin T from patients: an analytical imprecision- and partitioning-based approach
- Effect of preanalytical and analytical variables on the clinical utility of mean platelet volume
- Serum prolactin levels across pregnancy and the establishment of reference intervals
- Gender-partitioned patient medians of serum albumin requested by general practitioners for the assessment of analytical stability
- Cancer Diagnostics
- Detection of EGFR, KRAS and BRAF mutations in metastatic cells from cerebrospinal fluid
- Cardiovascular Diseases
- No additional value of conventional and high-sensitivity cardiac troponin over clinical scoring systems in the differential diagnosis of type 1 vs. type 2 myocardial infarction
- Letters to the Editor
- Rare inclusion bodies within monocytes at accelerated phase of Chediak-Higashi syndrome
- A specific abnormal scattergram of peripheral blood leukocytes that may suggest hairy cell leukemia
- Spuriously low lymphocyte count associated with pseudoerythroblastemia in a patient with chronic lymphocytic leukemia treated with ibrutinib
- Performance evaluation of a new automated fourth-generation HIV Ag/Ab combination chemiluminescence immunoassay
- False increase of glycated hemoglobin due to aspirin interference in Tosoh G8 analyzer
- Assessment of in vitro stability: a call for harmonization across studies
- Comparison between blood gas analyzer and central laboratory analyzer for the determination of electrolytes in patients with acute respiratory acidosis