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Biomedical subjects

Richard X Davey

Publications and source records attributed to Richard X Davey.

6 recordsLinked to original sources
PubMed2005

Troponin reporting in Australia in 2003.

BACKGROUND AND METHOD: This study uses a cross-sectional survey by questionnaire of Australia's pathology laboratories to describe how they report chemical markers for myocardial necrosis. RESULTS: The questionnaire was sent to 364 laboratories; 346 (95%) responded. Reporting data were obtained for 222 instruments used to analyse markers of myocardial necrosis, some 81% of all those in Australia. All laboratories use a troponin measurement. Reports from 132 analysers (59% of total) provide one cut-off point for the diagnosis of myocardial necrosis and 90 (41%) two cut-off points. The chosen cut-off points vary. The upper limit of 'healthy' is cited, alone, in 40 reports (18%); at this level, in 2002 no analysers predictably met required precision standards. Only 50% of all reports carry some explanatory comment; only 16% of all reports cite the source of the data. CONCLUSIONS: Troponin is used throughout Australia to help diagnose myocardial necrosis, but there is little order in the way the results are reported or interpreted.

Australia↗
PubMed2003

Troponin testing: an audit in three metropolitan hospitals.

OBJECTIVE: To audit the appropriateness of use of a troponin I assay in three hospitals. DESIGN: Cross-sectional survey of use of a troponin assay. SETTING: Three hospitals in Melbourne, Victoria, each with an emergency department and a coronary care unit. PARTICIPANTS: Patients for whom a troponin I assay was requested between 1 and 7 May 2002, 27-42 months after introduction of the assay. INTERVENTIONS: User-focused dissemination of relevant information, including protocols for use, from opinion leaders when the assay was introduced; continuous reinforcement of information in pathology reports. MAIN OUTCOME MEASURES: Adherence to protocol for assay use. RESULTS: Troponin assays were requested for 333 patients during 351 symptom episodes. A single assay was used in 194 symptom episodes (55%), and serial assays in 157 (45%); proportions were statistically indistinguishable across all three hospitals (chi(2); P = 0.71). Of the 194 single assays, 13 (7%) diagnosed a myocardial infarction. Serial troponin testing in all three hospitals followed the suggested protocol, with mean time between serial assays being more than 6 hours at all hospitals. CONCLUSIONS: Adherence to the protocol for serial troponin assay intervals was adequate, but single troponin assays were used extensively and probably inappropriately.

Biological Assay↗