title: Can Unmanned Aerial Systems (Drones) Be Used for the Routine Transport of Chemistry, Hematology, and Coagulation Laboratory Specimens?
abstract: BACKGROUND
  Unmanned Aerial Systems (UAS or drones) could potentially be used for the routine transport of small goods such as diagnostic clinical laboratory specimens. To the best of our knowledge, there is no published study of the impact of UAS transportation on laboratory tests.
  
  
  METHODS
  Three paired samples were obtained from each one of 56 adult volunteers in a single phlebotomy event (336 samples total): two tubes each for chemistry, hematology, and coagulation testing respectively. 168 samples were driven to the flight field and held stationary. The other 168 samples were flown in the UAS for a range of times, from 6 to 38 minutes. After the flight, 33 of the most common chemistry, hematology, and coagulation tests were performed. Statistical methods as well as performance criteria from four distinct clinical, academic, and regulatory bodies were used to evaluate the results.
  
  
  RESULTS
  Results from flown and stationary sample pairs were similar for all 33 analytes. Bias and intercepts were <10% and <13% respectively for all analytes. Bland-Altman comparisons showed a mean difference of 3.2% for Glucose and <1% for other analytes. Only bicarbonate did not meet the strictest (Royal College of Pathologists of Australasia Quality Assurance Program) performance criteria. This was due to poor precision rather than bias. There were no systematic differences between laboratory-derived (analytic) CV's and the CV's of our flown versus terrestrial sample pairs however CV's from the sample pairs tended to be slightly higher than analytic CV's. The overall concordance, based on clinical stratification (normal versus abnormal), was 97%. Length of flight had no impact on the results.
  
  
  CONCLUSIONS
  Transportation of laboratory specimens via small UASs does not affect the accuracy of routine chemistry, hematology, and coagulation tests results from selfsame samples. However it results in slightly poorer precision for some analytes.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Clinical Core Laboratory at Infectious Diseases Institute, Makerere University-Johns Hopkins University, Kampala, Uganda.
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Amukele
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Sokoll
authors.affiliation: University of Michigan Medical School, Ann Arbor, Michigan, United States of America.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pepper
authors.affiliation: NextGen Aeronautics, Torrance, California, United States of America.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Howard
authors.affiliation: NextGen Aeronautics, Torrance, California, United States of America.
authors.forename: Jeff
authors.initials: J
authors.lastname: Street
mesh_terms: D000328:Adult; D000401:Aircraft / Q000295:instrumentation*; D001780:Blood Coagulation Tests; D019963:Clinical Chemistry Tests; D005240:Feasibility Studies; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D008297:Male; D018962:Phlebotomy; D013048:Specimen Handling / Q000295:instrumentation*; D013997:Time Factors