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A common source of error in pH measurements.

Glass-electrode assemblies in which the reference half-cell contains a porous ceramic type of liquid junction are likely to produce misleading pH measurements under normal service conditions. The error arises from substantial liquid-junction potentials, associated with the porous ceramic plug, which vary with the ionic composition of the solution under test. The error is not revealed by conventional two-point calibration procedures, since the majority of standard buffer solutions have a similar total ionic strength, but will nevertheless be present when the unknown solution differs in ionic strength from the standardizing buffers. The size of the error is proportional to the ratio between the salt concentration in the standard buffers and the concentration present in the unknown solution, and varies from one electrode specimen to another. The fault was present in 24 out of 30 electrodes in normal use selected at random from seven laboratories, and the mean error was 0.2pH unit per 10-fold salt-concentration difference between standard and test solutions. It is estimated that errors of this order must be widespread in the recent literature. Older pH determinations are likely to be more reliable, since the original reference electrode design with a free-flowing liquid junction is apparently free from the artefact.

Buffers↗

Timing of quality of life (QoL) assessments as a source of error in oncological trials.

AIM OF THE STUDY: To produce an empirical estimate of the nature and magnitude of the error produced by incorrect timing quality of life (QoL) measurements in patients receiving chemotherapy. DESIGN: In a multicentre trial, 283 patients were randomized to receive either docetaxel (T) or sequential methotrexate and 5-fluorouracil (MF). The QoL was assessed at baseline and before each treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The study design was retrospective. Data were analysed using t-tests. RESULTS: Erroneous timing affected the QoL findings in both treatment arms. At baseline, there were statistically significant differences in the MF group on the nausea/vomiting scale, with ill-timed assessment showing more symptoms, and in the T group on the physical functioning scale with ill-timed assessments indicating better QoL. The mean scores of correct vs. incorrect timings over the first 14 cycles showed statistically significant differences on several scales. In the MF group, ill-timed assessments indicated significantly worse physical functioning and global QoL, and significantly more of the following symptoms: fatigue, nausea/vomiting, insomnia, appetite loss, and constipation. In the T group, ill-timed assessment showed better physical functioning, less dyspnoea and more insomnia than correctly timed assessments. The reasons for erroneous timing were not always detectable retrospectively. However, in some cases the MF group, being in standard treatment, seemed to have followed a clinical routine not involving the active participation of the study nurse responsible, whereas patients in the experimental T group were more consistently taken care of by the study nurses. CONCLUSIONS: Incorrect timing of QoL assessments in oncological trials jeopardises both the reliability of the QoL findings within treatment and the validity of QoL outcome comparisons between treatments. This issue should be emphasized in the planning of both the study design and clinical routines.

Activities of Daily Living↗

False localization of TMJ sounds to side is an important source of error in TMD diagnosis.

The results of the study indicate that the head tissues act as a band pass filter that is far from flat. Instead there seems to be strong frequency variations in attenuation of transmitted sounds. The sounds are subject to phase shift and time delay, which can be used to decide from which TMJ the sound comes. Bilateral electronic recording with high sampling rate (>> 44 kHz) is needed to accurately and consistently identify the origin of a TMJ sound. Further studies on autopsy specimens and large subject groups are motivated.

Acoustics↗

Another potential source of error in Rh-hr typing.

Three cases are presented in which the presence of sodium caprylate dependent albumin auto-agglutinins in the patients' sera resulted in erroneous Rh-hr phenotyping of their erythrocytes. In the initial testing, the albumin control was negative in each case. Since one of the cases was an Rh0(D) negative individual whose red blood cells might have been classified as Rh0(D) positive, a study was made using routine Rh-hr typing reagents from different manufacturers. Attention is drawn to the fact that Rh-hr typings should be performed using washed red blood cell samples when serum is known to contain albumin autoagglutinins.

Humans↗

Unbound immunoglobulins are a major source of error in the quantitation of platelet surface-bound immunoglobulin levels.

Analysis of assays for the determination of platelet-associated immunoglobulins (PAIgs) has led to disagreement over the amount of surface-bound Igs in both normal controls and patients with elevated platelet Ig levels. By the use of radiolabeled platelets and platelet counts, it was demonstrated that more than 10(8) platelets are disrupted after each centrifugation during platelet isolation procedures, releasing intraplatelet contents into the fluid phase of resuspended platelets in buffer. It was shown that suspensions of whole washed platelets contain a significant, but generally overlooked, amount of unbound Igs that have been liberated from platelets disrupted during processing. When platelet suspensions are evaluated for Igs with assays that fail to incorporate a final separation of whole platelets from the suspension fluid, unbound Igs as well as those bound to the platelet surface are measured, which yields a logarithmic overestimation of surface-bound Igs. It has been further demonstrated that patients infected with human immunodeficiency virus type 1 can have elevations of PAIgG, PAIgA, and PAIgM in both the thrombocytopenic and nonthrombocytopenic states. These elevations are due to increased internal platelet pools of Igs and not to increased surface-bound Igs.

Artifacts↗