Researches on iodine pools of muscular and adipose tissues. A preliminary communication.
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Biomedical subjects
Publications and source records attributed to R Malvano.
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The SimulTRAC FT4/TSH kit (Becton Dickinson), allowing a simultaneous determination of free thyroxine (FT4) and thyrotropin (TSH), was assessed in terms of analytical quality and clinical performance. The results of a multicenter trial were included in this study to obtain a more complete and reliable information. The current validation procedures (ie evaluation of analytical imprecision and sensitivity, between-kit comparison of estimates and--limited to TSH--check of response linearity on dilution) demonstrated quite acceptable analytical characteristics for both the FT4 and the TSH tests. The diagnostic sensitivity and predictive value were derived for separate and combined tests from a relatively large number of cases (ie 401 euthyroids, 127 overt and 48 subclinical hypothyroids, 205 overt and 80 compensated hyperthyroids). The TSH test proved more effective than FT4 in discriminating both overt and subclinical dysfunctions, and, in this respect, the test association was found to add a little advantage--if any. However, the extension of the concepts of diagnostic efficiency to any combination of test results--favoured by their production in a single assay--provides a basis to establish diagnostic protocols and to predict costs and benefits of medical actions.
Simulation procedures were applied to assess the response/error relationship (RER) and the imprecision profile (IP) for two model assays, a T4 RIA and a TSH IFMA both using duplicate samples. In order to define the reference functions, the mean data obtained in 10 successive experiments for dose/response curve (DR), RER and IP were employed. The following conclusions emerged from the study: (a) run sizes of ca. 100 duplicates can acceptably describe within-assay IPs, irrespective of the data distribution through the dose range; (b) the contribution of DR fitting error to the total variability of estimate can be disregarded in the case of small series but not for the larger ones; (c) the variability components related to the response error can be efficiently controlled by applying criteria based on RER parameters.
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