title: Comparison of serum calcium measurements with respect to five models of atomic absorption spectrometers using NBS-AACC calcium reference method and isotope-dilution mass spectrometry as the definitive method.
abstract: Utilizing the recently described reference method for calcium (NBS-AACC) and the recently developed definitive (referee) NBS method for serum calcium measurement by isotopedilution mass spectrometry (IDMS), an evaluation of five recent-model atomic absorption spectrometers was carried out. Under optimal conditions of instrument operation using aqueous standards, significant differences were found during the comparative analyses of three lyophilized pool samples and one liquid serum pool sample. Use of the NBS-AACC serum calcium protocol did not guarantee analytic results within +/- 2% of the IDMS value. In four of eight comparisons, differences from IDMS greater than 2% were observed. Several variables were studied to account for these differences. It was shown that a serum matrix, when present in standards used to bracket the unknown sample, reduced differences between instruments in four of four instances and improved the accuracy of the results from a range of -1.1 to +3.5% to +0.1 to +1.0%. It is concluded that a serum sample with a verified IDMS calcium value is a valuable tool that establishes an accurate and stable reference point for serum calcium measurement. The use of transfer-of-NBS-technology multipliers is suggested. Regional quality control serum pools and clinical chemistry survey sample materials that have been analyzed for calcium concentration by the NBS-IDMS definitive method are examples of these multipliers.
mesh_terms: D002118:Calcium / Q000097:blood*; D006801:Humans; D013058:Mass Spectrometry; D008722:Methods; D011865:Radioisotope Dilution Technique; D013054:Spectrophotometry, Atomic / Q000295:instrumentation*
chemical_list: D002118:Calcium