Confidence intervals and free prostate-specific antigen.
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Biomedical subjects
Publications and source records attributed to T Badrick.
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The prevalence of heterophilic antibody interference in a modern immunochemiluminometric assay containing blocking agents was determined using thyrotropin as an illustrative example. Serum samples were obtained from 295 consecutive patients who underwent routine thyroid function testing. The following versions of the thyrotropin assay were used: protocol A (zero blocker), protocol B (routine blocker concentration), and protocol C (extra blocker). Ten patients (prevalence 3.4%) had significant levels of heterophilic antibodies (protocol A value greater than 9 SD from the protocol B value). The observed thyrotropin levels for protocols B and C were the same for all patients, consistent with the reagent blockers in routine assays adequately eliminating heterophilic antibody interference. However, seven more patients (0.03%) in series of 21,000 assessed by routine thyroid function testing had discordant results because of a concentration of heterophilic antibodies so high as to overwhelm the added blocking agents.
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Increasingly heavy use is made of the pathology laboratory in many hospitals. This can cause problems, particularly with regard to urgent ("stat") tests, where a result is required in a short time. Many small laboratories are forced to offer a wide battery of tests, many of which may not help greatly in the acute diagnosis and/or management of the patient, and are expensive and inconvenient to perform. This paper addresses the questions as to which (chemical pathology) analytes should be available as emergency ("stat") tests, and how long should it take for results to come back.