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PubMedDate not supplied

Challenging the future. Clinical laboratory automation: a paradigm shift.

Compared to other industries, implementation of automation in the health-care arena has been delayed. Changes in reimbursement methods are forcing hospitals and other health-care providers to provide more cost-effective services. Clinical laboratory services are essential to the support of newer medical technologies and therapies such as organ transplantation and chemotherapy. The current paradigm for clinical laboratory operations is based on a mix of batch and random access testing and is dependent on personnel. In this article, a new paradigm based on a factory automation model is described. Mechanisms to support the paradigm shift--including a proposal for the creation of a consortium to jointly fund a development operation--are also explored. A clinical laboratory platform prototype currently under development at the University of Nebraska Medical Center is also described.

Academic Medical Centers↗
PubMed1999

The microbial proteome database--an automated laboratory catalogue for monitoring protein expression in bacteria.

Laboratories devoted to high-throughput characterisation of purified proteins arrayed via two-dimensional (2-D) gel electrophoresis face an arduous task in maintaining a centralised and constantly evolving record of information relating to the characterisation of proteins and their responses following biological challenges. The Microbial Proteome Database (MPD) has been conceived as an in-house resource for complementing the plethora of genomic databases available for such organisms. The database utilises commercially available software to provide an electronic 'lab book' of information obtained daily from 2-D electrophoresis gels, image analysis packages, protein characterisation methodologies, and biological experimentation. The MPD begins from a single 2-D gel image (a 2-D 'reference map') with clickable spots that link to a 'protein catalogue' (ProtCat) with spot information including protein identity, changes in expression determined under experimental conditions, cellular location, mass, and pI. The entry for each protein then contains further links to gel images corresponding to the presence of the particular protein within different subproteomes (as defined by the pH of narrow- and wide-range immobilised pH gradients or from differential extraction methods used to determine the location of the protein within a functional cell). The database currently contains information from strains of three microbial species (Escherichia coil, Pseudomonas aeruginosa and Staphylococcus aureus) and 32 master gel images. The rapid accessibility of information obtained from microbial proteomes is an essential step towards the integrated analysis of these organisms at the gene, transcript, protein and functional levels and will aid in reducing turnaround times between sample preparation and the discovery of molecules of biological significance.

Automation↗
PubMed1975

Laboratory automation of high-pressure liquid chromatography.

An automated system for high-pressure liquid chromatography was developed. The system is built around commercial modules wherever possible, modified to varying degrees. An automatic sampler, a sample pump, a high-pressure sampling valve, a recorder with an integrator, and a high-pressure liquid chromatograph comprise the commercial instruments. Relays, solenoid valves, and timers control chromatographic events, i.e., duration of sampling and rinse, mobile phase pump refill, sample injection, and chromatographic time. The automated system is dependable over long periods of unattended operation. With the 40-sample capacity of the sample tray and the last sample stop capability, the automated system produces, for example, 40 20-min chromatograms in approximately 13 hr of unattended operation. Data demonstrate the reliability and utility of the system.

Automation↗
PubMed1976

An automated laboratory control system: collection and analysis of behavioral and electro-physiological data.

A system of man-machine interactive PDP-11 assembly language programs is described which presents stimuli to a subject and records and analyzes behavioral and evoked potential data. The system was designed for researchers with no knowledge of computer programming and enables the user to create complicated sequences of stimulus presentations ("trials") and sequences of successive trials ("runs"), with no new programming required. The system is written for DEC.s DECLAB 11/40 system.

Behavior↗
PubMed1996

Automated laboratory protocols.

A protocol is a program which controls, monitors and modifies the requests for laboratory services during the diagnostic work-up and/or monitoring of a patient. A protocol language and an OS/2 based system for the compilation, interpretation and execution of laboratory protocols written in this language is presented. The system is easily interfaced with any patient data base that supports the structured query language (SQL). A compiled protocol may be assigned to a patient and executed as specified in the protocol itself (regularly and/or when certain events such as test requests or arrival of results, occur). In the laboratory protocol language a patient's data are viewed as a set of test procedure groups each comprising data (request time, result, etc.) describing the status of one or more simultaneously made laboratory test requests. A pattern specification is a statement saying that a sequence of test procedure groups of specified types and ages is present in the data. Pattern specifications are linked to Boolean variables. If a pattern matching a pattern specification is found in the patient's database the corresponding Boolean variable is set equal to TRUE. The Boolean variables are utilized in the decision logic of the protocol.

Algorithms↗
PubMed1999

Comparison of self-reported fecal occult blood testing with automated laboratory records among older women in a health maintenance organization.

Screening guidelines for colorectal cancer recommend annual fecal occult blood (FOB) testing for adults aged 50 years and older. Self-reported history of screening is frequently the sole source of data available to researchers and clinicians. This study validated FOB testing in a sample of 1,021 older women. Testing rates based on self-reported data exceeded rates based on computerized laboratory records by 13.9%. Agreement was moderate (kappa = 0.52; 95% confidence interval 0.47, 0.58). Sensitivity was 0.92 and specificity 0.58. Logistic regression analysis showed that older age and physician encouragement for FOB testing were associated with accurate recall (p<0.05). Self-report is the most commonly available information about the occurrence and timing of cancer detection procedures. These data suggest cautious use of self-reported screening by FOB for clinical decision making and for research and surveillance.

Aged↗