Validity of standard reference values irrespective of rest and time of day prior to blood sampling-results from albumin and thyrotropin

I. B. Andersen, C. L. Brasen, H. Christensen, D. E. Nielsen, I. Brandslund, Jonna Skov Madsen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskning

Resumé

Background: Preanalytical factors affects different biochemical parameters. Therefore reference intervals are recommended to apply to rules of standardization that state that blood samples should be taken in the morning after 15 min rest. However, both hospital and patients have a wish to minimize waiting time prior to blood sampling. Moreover, some parameters have diurnal variation and since there is a growing desire to expand opening hours in the clinics this variation is worth investigating further. Therefore our aim is to test whether the reference intervals of albumin and thyrotropin are valid throughout the opening hours and investigate the impact of resting time. Materials and method: All patients referred to an outpatient clinic for blood sampling were included during Nov. 2011-Jun. 2014 (opening hours: 7am-3pm). For each patient arrival time and time of blood sampling were registered electronically using Q-MATIC Suite. Impact of resting time and time of day on thyreotropin and albumin values was analyzed using a simple linear regression. The "maximum allowable bias" was used as quality indicator for the reference interval. Results: Using linear regression we found significant diurnal variation and influence by resting time for albumin (n = 15,544) and thyrotropin (n = 20,019) with p-values: 0.004 (rest) and <2x10-16 (diurnal) for thyrotropin, 2.6x10-4 (rest) and <2x10-16 (diurnal) for albumin. For albumin the maximum allowable bias never exceeded limits for accepting reference values for any resting time or time of day (but was on limit at 3pm). Thyrotropin concentration decreased from 7-9am. After 9am the change exceeded maximum allowable bias. For the resting no pattern was observed. Conclusion: It is not necessary to wait 15 min prior to blood sampling. Albumin may need a change of reference interval if opening hours is expanded. Thyrotropin diurnal variation is very important and change of procedure or reference interval is necessary.
OriginalsprogEngelsk
ArtikelnummerP184
TidsskriftClinical Chemistry and Laboratory Medicine
Vol/bind53
Udgave nummer4
Sider (fra-til)eA88
ISSN1434-6621
DOI
StatusUdgivet - 2015
Begivenhed3rd EFLM-BD European Conference on Preanalytical Phase - Porto, Portugal
Varighed: 20. mar. 201521. mar. 2015

Konference

Konference3rd EFLM-BD European Conference on Preanalytical Phase
LandPortugal
ByPorto
Periode20/03/201521/03/2015

Emneord

  • *reference value *European *blood sampling *validity *circadian rhythm concentration (parameters) human patient linear regression analysis parameters hospital procedures statistical significance standardization outpatient department *albumin *thyrotropin nitrogen 15 immunoferon

Citer dette

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title = "Validity of standard reference values irrespective of rest and time of day prior to blood sampling-results from albumin and thyrotropin",
abstract = "Background: Preanalytical factors affects different biochemical parameters. Therefore reference intervals are recommended to apply to rules of standardization that state that blood samples should be taken in the morning after 15 min rest. However, both hospital and patients have a wish to minimize waiting time prior to blood sampling. Moreover, some parameters have diurnal variation and since there is a growing desire to expand opening hours in the clinics this variation is worth investigating further. Therefore our aim is to test whether the reference intervals of albumin and thyrotropin are valid throughout the opening hours and investigate the impact of resting time. Materials and method: All patients referred to an outpatient clinic for blood sampling were included during Nov. 2011-Jun. 2014 (opening hours: 7am-3pm). For each patient arrival time and time of blood sampling were registered electronically using Q-MATIC Suite. Impact of resting time and time of day on thyreotropin and albumin values was analyzed using a simple linear regression. The {"}maximum allowable bias{"} was used as quality indicator for the reference interval. Results: Using linear regression we found significant diurnal variation and influence by resting time for albumin (n = 15,544) and thyrotropin (n = 20,019) with p-values: 0.004 (rest) and <2x10-16 (diurnal) for thyrotropin, 2.6x10-4 (rest) and <2x10-16 (diurnal) for albumin. For albumin the maximum allowable bias never exceeded limits for accepting reference values for any resting time or time of day (but was on limit at 3pm). Thyrotropin concentration decreased from 7-9am. After 9am the change exceeded maximum allowable bias. For the resting no pattern was observed. Conclusion: It is not necessary to wait 15 min prior to blood sampling. Albumin may need a change of reference interval if opening hours is expanded. Thyrotropin diurnal variation is very important and change of procedure or reference interval is necessary.",
keywords = "*reference value *European *blood sampling *validity *circadian rhythm concentration (parameters) human patient linear regression analysis parameters hospital procedures statistical significance standardization outpatient department *albumin *thyrotropin nitrogen 15 immunoferon",
author = "Andersen, {I. B.} and Brasen, {C. L.} and H. Christensen and Nielsen, {D. E.} and I. Brandslund and Madsen, {Jonna Skov}",
year = "2015",
doi = "10.1515/cclm-2015-0091",
language = "English",
volume = "53",
pages = "eA88",
journal = "Clinical Chemistry and Laboratory Medicine",
issn = "1434-6621",
publisher = "Walterde Gruyter GmbH",
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Validity of standard reference values irrespective of rest and time of day prior to blood sampling-results from albumin and thyrotropin. / Andersen, I. B.; Brasen, C. L.; Christensen, H.; Nielsen, D. E.; Brandslund, I.; Madsen, Jonna Skov.

I: Clinical Chemistry and Laboratory Medicine, Bind 53, Nr. 4, P184, 2015, s. eA88.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskning

TY - ABST

T1 - Validity of standard reference values irrespective of rest and time of day prior to blood sampling-results from albumin and thyrotropin

AU - Andersen, I. B.

AU - Brasen, C. L.

AU - Christensen, H.

AU - Nielsen, D. E.

AU - Brandslund, I.

AU - Madsen, Jonna Skov

PY - 2015

Y1 - 2015

N2 - Background: Preanalytical factors affects different biochemical parameters. Therefore reference intervals are recommended to apply to rules of standardization that state that blood samples should be taken in the morning after 15 min rest. However, both hospital and patients have a wish to minimize waiting time prior to blood sampling. Moreover, some parameters have diurnal variation and since there is a growing desire to expand opening hours in the clinics this variation is worth investigating further. Therefore our aim is to test whether the reference intervals of albumin and thyrotropin are valid throughout the opening hours and investigate the impact of resting time. Materials and method: All patients referred to an outpatient clinic for blood sampling were included during Nov. 2011-Jun. 2014 (opening hours: 7am-3pm). For each patient arrival time and time of blood sampling were registered electronically using Q-MATIC Suite. Impact of resting time and time of day on thyreotropin and albumin values was analyzed using a simple linear regression. The "maximum allowable bias" was used as quality indicator for the reference interval. Results: Using linear regression we found significant diurnal variation and influence by resting time for albumin (n = 15,544) and thyrotropin (n = 20,019) with p-values: 0.004 (rest) and <2x10-16 (diurnal) for thyrotropin, 2.6x10-4 (rest) and <2x10-16 (diurnal) for albumin. For albumin the maximum allowable bias never exceeded limits for accepting reference values for any resting time or time of day (but was on limit at 3pm). Thyrotropin concentration decreased from 7-9am. After 9am the change exceeded maximum allowable bias. For the resting no pattern was observed. Conclusion: It is not necessary to wait 15 min prior to blood sampling. Albumin may need a change of reference interval if opening hours is expanded. Thyrotropin diurnal variation is very important and change of procedure or reference interval is necessary.

AB - Background: Preanalytical factors affects different biochemical parameters. Therefore reference intervals are recommended to apply to rules of standardization that state that blood samples should be taken in the morning after 15 min rest. However, both hospital and patients have a wish to minimize waiting time prior to blood sampling. Moreover, some parameters have diurnal variation and since there is a growing desire to expand opening hours in the clinics this variation is worth investigating further. Therefore our aim is to test whether the reference intervals of albumin and thyrotropin are valid throughout the opening hours and investigate the impact of resting time. Materials and method: All patients referred to an outpatient clinic for blood sampling were included during Nov. 2011-Jun. 2014 (opening hours: 7am-3pm). For each patient arrival time and time of blood sampling were registered electronically using Q-MATIC Suite. Impact of resting time and time of day on thyreotropin and albumin values was analyzed using a simple linear regression. The "maximum allowable bias" was used as quality indicator for the reference interval. Results: Using linear regression we found significant diurnal variation and influence by resting time for albumin (n = 15,544) and thyrotropin (n = 20,019) with p-values: 0.004 (rest) and <2x10-16 (diurnal) for thyrotropin, 2.6x10-4 (rest) and <2x10-16 (diurnal) for albumin. For albumin the maximum allowable bias never exceeded limits for accepting reference values for any resting time or time of day (but was on limit at 3pm). Thyrotropin concentration decreased from 7-9am. After 9am the change exceeded maximum allowable bias. For the resting no pattern was observed. Conclusion: It is not necessary to wait 15 min prior to blood sampling. Albumin may need a change of reference interval if opening hours is expanded. Thyrotropin diurnal variation is very important and change of procedure or reference interval is necessary.

KW - reference value European blood sampling validity circadian rhythm concentration (parameters) human patient linear regression analysis parameters hospital procedures statistical significance standardization outpatient department albumin thyrotropin nitroge

U2 - 10.1515/cclm-2015-0091

DO - 10.1515/cclm-2015-0091

M3 - Conference abstract in journal

VL - 53

SP - eA88

JO - Clinical Chemistry and Laboratory Medicine

JF - Clinical Chemistry and Laboratory Medicine

SN - 1434-6621

IS - 4

M1 - P184

ER -