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Maria Stella Graziani

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Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

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Giuseppe Agosta

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email: biochimica.clinica@sibioc.it



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BC: Articoli scritti da R. Dittadi

La fase pre-analitica dei campioni provenienti dal Pronto Soccorso: impatto della introduzione di un impianto di posta pneumatica nel miglioramento del tempo di risposta
Improving pre-analytical laboratory turnaround time for the emergency department: outcomes of a pneumatic tube system introduction
<p>Background: the pre-analytical phase of the stat tests requested by the Emergency Department (ED) has been rarelystudied in relation to the containment of the laboratory turnaround time (TAT).<br />Methods: through a pre-analytical workflow analysis in a large ED with &quot;Lean&quot; methodology, some improvementshave been activated, including the installation of a pneumatic tube system (PTS).<br />Results: significant improvement of TATs (23 minutes at 90th percentile) and also of length of stay (LOS) of EDpatients (53 minutes at 90th percentile) has been documented. The plasma concentrations of a number of analytesmeasured in samples transported manually and by PTS were very similar (lactic dehydrogenase excluded),demonstrating that PTS does not alter the integrity of the samples.<br />Conclusions: compared to manual transportation, the use of this PTS significantly reduced transport time and alsoimproved some pre-analytical flow phases within the ED. The system is suitable for the measurement of most of theanalytes commonly requested for ED patients.</p>
Biochimica Clinica ; 43(2) 150-155
Contributi Scientifici - Scientific Papers
 
Protocollo operativo per la verifica della comparabilità dei risultati di laboratorio ottenuti su più procedure analitiche
Protocol to verify the comparability of quantitative laboratory results obtained with different measurementprocedures.
<p>With the growth and merging of clinical laboratories, very frequently analytical tests are performed onmultiple instruments within one or multiple locations. In these situations, there is the need of verifying thecomparability of patient results obtained with different analysers and/or different measurement procedures. Theimportance of this verification is further emphasised when considering that it is included into the ISO 15189specifications. This protocol provides step-by-step guidance on how to assess results comparability in differentscenarios. Up to four experimental designs are presented to meet laboratories&rsquo; needs, with details and examples onfrequency of testing, definition of acceptability criteria, samples selection, sample size calculation, statistical analysisand reporting.</p>
Biochimica Clinica ; 43(2) 228-243
Documenti SIBioC - SIBioC Documents
 
Protocollo per la comparazione di due metodi analitici di laboratorio
Protocol for the comparison of two laboratory methods
<p>Method comparison is one of the main concerns in&nbsp;Laboratory Medicine. With the introduction of new methods with potential advantages (e.g., cost reduction, improvement&nbsp;in efficiency, easier procedures and maintenance) the laboratory staff should investigate if the field method in use may&nbsp;be replaced by the new candidate method without compromising analytical quality nor resulting in a different medical&nbsp;decision or patient management. Several statistical approaches and graphical tools are available to investigate sources&nbsp;of analytical error and for decision-making. In this article, we present an operative protocol for the comparison of two&nbsp;quantitative analytical methods. All sequential steps, including experimental design, familiarization with the new method,&nbsp;quality assessment, sample selection, definition of acceptability criteria, sample measurement, data analysis and&nbsp;evaluation, final decision and reporting, are discussed and exemplified.</p>
Biochimica Clinica ; 40(2) 129-142
Documenti SIBioC - SIBioC Documents
 
Calcolo e valutazione dei valori di riferimento della troponina cardiaca I (cTnI) misurata in un gruppo di volontari sani italiani con metodi immunometrici ad alta sensibilità: uno studio multicentrico
Establishment and evaluation of cardiac troponin I reference values measured in a group of Italian healthy volunteers using high-sensitivity methods: a multi-center study.
<p>Introduction: this study compares the cardiac troponin I (cTnI) values measured with three high-sensitivity (hs) different methods in apparently healthy volunteers enrolled in a multicenter study.<br />Methods: heparinized plasma samples were collected from 1511 volunteers in 8 Italian clinical institutions (mean age 51.5 years, SD 14.2, range 18-86, female to male ratio 0.94). All volunteers denied chronic or acute diseases and had normal values of routine laboratory tests and ECG. The reference laboratory of the study (Laboratorio Fondazione CNR Regione Toscana G. Monasterio, Pisa, Italy) assayed all plasma samples with three hs-methods: Architect hs-cTnI, Access hs-cTnIand ADVIA Centaur XPT hs-cTnI. After the exclusion of outlier values, calculation of 99th percentile (Upper Reference Limit, URL) values was performed using both robust nonparametric and bias corrected and accelerated bootstrap methods.<br />Results: large between-method differences were found. ADVIA Centaur measured higher cTnI values (up to 2-fold) than the two other methods. cTnI values were significantly higher in men than in women, and progressively increased with age over 55 years. Moreover, 99th percentile URL values also depended on the statistical approach used for calculation (robust non-parametric versusbootstrap). All 99th percentile URL values calculated with non-parametric robust method were on average slightly lower than those suggested by manufacturers (mean difference 4.2 ng/L, standard error 1.7, p=0.0273).<br />Conclusion: clinicians should be advised that plasma samples from the same patient should be measured for hs-cTnI in the same laboratory. Specific clinical studies are needed to establish the most appropriate statistical approach to calculate 99th percentile URL values for hs-cTnI methods.</p>
Biochimica Clinica ; 17(1)
Contributi Scientifici - Scientific Papers