Printed from acutecaretesting.org
Articles
Showing all articles
Article
April 2010
Benefit of using a D-dimer assay with a high clinical specificity
CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS).
Improving specificity of D-dimer assays would...
Coagulation/fibrinolysis
D-dimer
Article
January 2010
Verification of methods and instruments
Analytical methods are often developed at one site and
transferred to other sites for routine use. Increasingly, the
method development is made by manufacturers of instruments and
reagents. Regulatory agencies have ruled that the
responsibility for the performance of IVDs in the laboratories
mainly should lie with...
Quality assurance
Creatinine/urea
Article
January 2010
Comparing D-dimer assays
When a new D-dimer method is to be implemented either as a substitute for a currently used D-dimer assay or as a supplement, maybe as a point-of-care assay, it is necessary to do a clinical comparison of the "old" assay versus the "new" assay. The major pitfalls in D-dimer comparisons are addressed in this paper.
...
Coagulation/fibrinolysis
D-dimer
Article
October 2009
D-dimer testing in the treatment and monitoring of septic patients
Sepsis and septic shock lead to local and systemic
activation of different response systems, including coagulation and
fibrinolysis.
Despite numerous attempts the high mortality rate of
these patients has remained stable over the last 20
years.
In this overview the pathophysiological insights and
possible...
Coagulation/fibrinolysis
D-dimer
Article
October 2009
Low troponin I concentrations and clinical decision making
Troponin values above the 99th percentile and increasing/falling values found by serial testing in addition to signs and symptoms of myocardial ischemia means AMI.
Low troponin values, near or below the 99th percentile, can be used for prognosis. Highest hazard ratios were found when using the 90th percentile,...
Cardiac markers
Troponins
Natriuretic peptide
Article
October 2009
Clinical aspects of pleural fluid pH
Pleural effusion, defined as excess fluid in the pleural space, can complicate the course of a large and pathologically diverse range of pulmonary and non-pulmonary diseases. Laboratory analysis of pleural fluid provides much useful information for the clinician whose diagnostic challenge is the patient presenting...
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Hemoglobins
Article
July 2009
Clinical aspects of the anion gap
The anion gap (AG) is a calculated parameter derived from measured serum/plasma electrolyte concentrations. The clinical value of this calculated parameter is the main focus of this article.
Both increased and reduced anion gap have clinical significance, but the deviation from normal that has most clinical...
Electrolytes
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
Kidneys/fluids
Article
June 2009
Diagnostic accuracy – Part 1
Basic concepts: sensitivity and specificity, ROC analysis, STARD statement
The discriminative ability of a diagnostic procedure is called diagnostic accuracy, and a number of quantitative measures out of which sensitivity and specificity are mostly used in the biomedical literature can express it.
Each diagnostic-accuracy measure relates to some specific aspects of a diagnostic procedure....
Information management
Article
June 2009
Acute care testing at the point-of-care: now and in the future
The field of point-of-care testing (POCT) is entering a period of rapid expansion. This expansion is being driven by new evidence for clinical effectiveness of POCT, and new technologies that allow consolidation of testing onto smaller platforms.
Technological improvements will also lead to increased accuracy for...
Glucose
Blood gases/acid-base
Point-of-care testing
Quality assurance
Lactate
Creatinine/urea
Hemoglobins
Kidneys/fluids
Article
June 2009
The utility of natriuretic peptide in the management of patients with acute and chronic heart failure: Insights from randomized controlled trials
Patients with heart failure (HF) experience significant morbidity and mortality and those admitted for acute decompensated HF are at particularly high risk for adverse events.
Hospitalization represents the major component of the high cost associated with the management of patients with HF. Accordingly, early and...
Cardiac markers