title: Systematical assessment of serum indices does not impair efficiency of clinical chemistry testing: a multicenter study.
abstract: OBJECTIVE
  Despite manufacturers' claim that systematical assessment of serum indices does not impact on testing efficiency, there is widespread perception that this practice may increase the turnaround time (TAT). A multicenter investigation was planned to verify TAT and performance of serum indices on five different clinical chemistry analyzers.
  
  
  METHODS
  Twenty study samples prepared from pooled sera of outpatients, emergency department, intensive care unit and dialyzed patients were divided in aliquots and shipped to 5 different laboratories. According to local instrumentation (Beckman Coulter AU5800, Roche Cobas 6000, Siemens Dimension Vista 1500, Abbott Architect c 16000 and Ortho Vitros 5.1/FS) and reagents, 13 clinical chemistry parameters were assayed on all study samples, with or without contextual assessment of serum indices.
  
  
  RESULTS
  The TAT with assessment of serum indices modestly or even negligibly increased, and varied from -0.2 to +5.0% (i.e., from -3 to +85 s). When using the lowest thresholds for sample acceptability, the agreement of hemolysis index (HI) among different instruments was comprised between 0.62 and 1.00 (all p<0.01), but was higher than 0.80 in only 4/10 cases. The agreement of icteric and lipaemic indices could not be estimated due to the low number of samples exceeding acceptability criteria.
  
  
  CONCLUSIONS
  The results of this study confirm that systematical measurement of serum indices does not impair instrument efficiency. The comparison of HI also suggests that major harmonization may be advisable for this measure among different manufacturers and instrumentations.
authors.affiliation: Unità Operativa Diagnostica Ematochimica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. glippi@ao.pr.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Paola
authors.initials: P
authors.lastname: Avanzini
authors.forename: Daniele
authors.initials: D
authors.lastname: Campioli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Da Rin
authors.forename: Mariella
authors.initials: M
authors.lastname: Dipalo
authors.forename: Rosalia
authors.initials: R
authors.lastname: Aloe
authors.forename: Davide
authors.initials: D
authors.lastname: Giavarina
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
mesh_terms: D000328:Adult; D001774:Blood Chemical Analysis; D019963:Clinical Chemistry Tests / Q000592:standards*; D004526:Efficiency; D005260:Female; D006461:Hemolysis; D006801:Humans; D007753:Laboratories; D008297:Male; D012494:Sampling Studies; D044967:Serum / Q000737:chemistry*
keywords: Hemolysis; Preanalytical variability; Sample quality; Serum indices