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Orth M, Vollebregt E, Trenti T, Shih P, Tollanes M, Sandberg S. Direct-to-consumer laboratory testing (DTCT): challenges and implications for specialists in laboratory medicine. Clin Chem Lab Med 2023; 61:696-702. [PMID: 36565304 DOI: 10.1515/cclm-2022-1227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
In vitro diagnostics (IVD) testing is a powerful tool for medical diagnosis, and patients' safety is guaranteed by a complex system of personnel qualification of the specialist in laboratory medicine, of process control, and legal restrictions in healthcare, most of them under national regulation. Direct-to-consumer laboratory testing (DTCT) is testing ordered by the consumer and performed either by the consumer at home or analysis of self-collected samples in a laboratory. However, since DTCT are not always subject to effective competent authority oversight, DTCT may pose risks to lay persons using and relying on it for healthcare decision-making. Laboratory medicine specialists should be very cautious when new DTCTs are introduced. As qualified professionals, they should feel obliged to warn and educate patients and the public about the risks of inappropriate and harmful DTCT.
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Affiliation(s)
- Matthias Orth
- Vinzenz von Paul Kliniken gGmbH, Institut für Laboratoriumsmedizin, Stuttgart, Germany
- Medizinische Fakultät Mannheim, Ruprecht Karls Universität, Mannheim, Germany
| | | | - Tomaso Trenti
- Dipartimento Integrato Interaziendale di Medicina di Laboratorio e Anatomia Patologica, Azienda Ospedaliera Universitaria e Azienda USL di Modena, Modena, Italy
| | - Patti Shih
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong NSW, Wollongong, Australia
| | - Mette Tollanes
- Norwegian Organisation for Quality Improvement of Laboratory Examinations (NOKLUS), Bergen, Norway
- Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Sverre Sandberg
- Norwegian Organisation for Quality Improvement of Laboratory Examinations (NOKLUS), Bergen, Norway
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Lu X, Zhang M, Liu W, Sheng N, Du Q, Zhang M, Guo X, Wang G, Wang Q. A method to alleviate false-positive results of the Elecsys HIV combi PT assay. Sci Rep 2021; 11:1033. [PMID: 33441741 PMCID: PMC7807026 DOI: 10.1038/s41598-020-80047-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/16/2020] [Indexed: 11/09/2022] Open
Abstract
To explore the effects of urea dissociation on reducing false-positive results of the Elecsys HIV combi PT assay. A retrospective analysis was used to evaluate the false-positive rate of the Elecsys HIV combi PT assay. Six false-positive sera, six positive sera and six sera from patients with early HIV infection were collected. Dissociation was performed using 1 mol/L, 2 mol/L, 4 mol/L, 6 mol/L, or 8 mol/L urea, and HIV screening assay were then detected to select the appropriate concentration of urea dissociation. Next, 55 false-positive sera and 15 sera from early HIV infection were used to verify the best concentration of urea to achieve dissociation. Retrospective analysis showed that the COI of the Elecsys HIV combi PT assay in false-positive sera ranged from 1.0 to 200.0, and approximately 97.01%(227/234) of false-positive sera were in the range of 1.0-15.0. The avidity index (AI) in positive and false-positive sera decreased as the urea dissociation concentration increased. When the dissociation concentration was 6 mol/L, the AI of false-positive serum was between 0.0234 and 0.2567, and the AI of early HIV infection sera was between 0.4325 and 0.5017. The difference in AI between false-positive and positive samples was significant. When negativity was defined as an AI of less than 0.3970, the sensitivity and specificity were 100.0% and 100.0%, respectively. Urea-mediated dissociation could significantly reduce the false-positive rate of the Elecsys HIV combi PT assay with a low COI. Our findings provided a reference for distinguishing positive and false-positive of the Elecsys HIV combi PT assay.
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Affiliation(s)
- Xiaolan Lu
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
| | - Minghong Zhang
- Nanchong Center for Disease Control and Prevention, Nanchong, Sichuan, People's Republic of China
| | - Wen Liu
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
| | - Nan Sheng
- Nanchong Center for Disease Control and Prevention, Nanchong, Sichuan, People's Republic of China
| | - Qin Du
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
| | - Maoxin Zhang
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
| | - Xiaolan Guo
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China
| | - Guangrong Wang
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. .,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. .,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
| | - Qiang Wang
- Department of Laboratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. .,College of Laboratory Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. .,Faculty of Laboratory Medicine, Center for Translational Medicine, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.
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