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Insufficient mixing of thawed serum samples leading to erroneous results–experience from a field study and use of a correction procedure

Ekström, Ulf LU ; Apelqvist, Jenny LU ; Hansson, Erik LU ; Bodin, Theo LU ; Wegman, David H. ; Abrahamson, Magnus LU and Jakobsson, Kristina (2020) In Scandinavian Journal of Clinical and Laboratory Investigation 80(2). p.99-105
Abstract

Incorrect analysis results that are close to expected might not be recognized in scientific studies or routine patient care. In two field studies we obtained unexpected results in a large number of samples. The present study aimed to identify the source of error in the samples from these studies and to validate a method to obtain correct results. Pre-analytical procedures were scrutinized, giving no indications of inappropriate pre-analytical sample handling in the field or during transport in a tropical climate. Using a new set of samples from volunteers in simulation experiments, we observed the known concentration gradient of analytes sampled in gel as well as plain tubes after freezer storage and thawing. Experiments demonstrated... (More)

Incorrect analysis results that are close to expected might not be recognized in scientific studies or routine patient care. In two field studies we obtained unexpected results in a large number of samples. The present study aimed to identify the source of error in the samples from these studies and to validate a method to obtain correct results. Pre-analytical procedures were scrutinized, giving no indications of inappropriate pre-analytical sample handling in the field or during transport in a tropical climate. Using a new set of samples from volunteers in simulation experiments, we observed the known concentration gradient of analytes sampled in gel as well as plain tubes after freezer storage and thawing. Experiments demonstrated that mixing of samples by vortexing alone was not sufficient to disrupt the gradient formed by freezing and thawing, which appeared to cause the problem encountered when we in field studies analyzed and biobanked large sample sets by robot pipetting. A correction procedure was introduced, in which the obtained value of an analyte was multiplied by a correction factor calculated for each sample using the expected sodium level (140 mmol/L) divided by the measured sodium value. When it was validated on results from the simulation experiments, we repeatedly found that the correction lead to results very close to true values for analytes of different size and charge. Usefulness of the procedure was demonstrated when applied to a large set of field study results.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
analytic sample preparation methods, Chemistry, clinical, clinical laboratory techniques, diagnostic tests, Pre-analytical phase, routine, specimen handling
in
Scandinavian Journal of Clinical and Laboratory Investigation
volume
80
issue
2
pages
7 pages
publisher
Informa Healthcare
external identifiers
  • pmid:31847598
  • scopus:85076905901
ISSN
0036-5513
DOI
10.1080/00365513.2019.1700425
language
English
LU publication?
yes
id
8cfbda47-3c92-4c8c-b489-3007669f7ace
date added to LUP
2020-01-10 14:53:16
date last changed
2024-03-04 11:16:19
@article{8cfbda47-3c92-4c8c-b489-3007669f7ace,
  abstract     = {{<p>Incorrect analysis results that are close to expected might not be recognized in scientific studies or routine patient care. In two field studies we obtained unexpected results in a large number of samples. The present study aimed to identify the source of error in the samples from these studies and to validate a method to obtain correct results. Pre-analytical procedures were scrutinized, giving no indications of inappropriate pre-analytical sample handling in the field or during transport in a tropical climate. Using a new set of samples from volunteers in simulation experiments, we observed the known concentration gradient of analytes sampled in gel as well as plain tubes after freezer storage and thawing. Experiments demonstrated that mixing of samples by vortexing alone was not sufficient to disrupt the gradient formed by freezing and thawing, which appeared to cause the problem encountered when we in field studies analyzed and biobanked large sample sets by robot pipetting. A correction procedure was introduced, in which the obtained value of an analyte was multiplied by a correction factor calculated for each sample using the expected sodium level (140 mmol/L) divided by the measured sodium value. When it was validated on results from the simulation experiments, we repeatedly found that the correction lead to results very close to true values for analytes of different size and charge. Usefulness of the procedure was demonstrated when applied to a large set of field study results.</p>}},
  author       = {{Ekström, Ulf and Apelqvist, Jenny and Hansson, Erik and Bodin, Theo and Wegman, David H. and Abrahamson, Magnus and Jakobsson, Kristina}},
  issn         = {{0036-5513}},
  keywords     = {{analytic sample preparation methods; Chemistry; clinical; clinical laboratory techniques; diagnostic tests; Pre-analytical phase; routine; specimen handling}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{99--105}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Clinical and Laboratory Investigation}},
  title        = {{Insufficient mixing of thawed serum samples leading to erroneous results–experience from a field study and use of a correction procedure}},
  url          = {{http://dx.doi.org/10.1080/00365513.2019.1700425}},
  doi          = {{10.1080/00365513.2019.1700425}},
  volume       = {{80}},
  year         = {{2020}},
}