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Introduction This article features a general background of the analytical characteristics associated with cardiac troponin testing. It addresses the following areas: Introduction to troponin What is the 99^th percentile upper reference limit (URL) and why do we use it? Determination of the 99^th percentile...

Introduction Since the first publications on cardiac troponin (cTn) in the 1970s, around 20.000 scientific reports on this powerful biomarker of myocardial injury have been published. Over time, cTn assays improved their analytical performance and became the designated biomarker for ruling out or ruling in acute...

This article explores the potential benefits of point-of-care testing in the ED. Price and St. John provide a detailed description on how to approach four common aspects of point-of-care testing (POCT) in the ED, specifically, the challenges of adopting POCT, the impact of POCT on clinical decisions, the impact of...

Summary The reference interval for a biochemical analyte is usually an interval of values bounded by the reference limit values at certain designated percentiles [1].  As always when choosing a cut-off, the value will determine the trade-off between clinical sensitivity and specificity. When a low cut-off is chosen,...

This article discusses the use of a D-dimer assay in excluding venous thromboembolism (VTE) in outpatients. Together with a low pretest probability of VTE, a negative D-dimer test can rule out VTE in 30-50 % of suspected patient cases. The article highlights the importance of using a D-dimer assay with particular...

Reprinted with permission from Biochemia Medica. The journal of Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochemia Medica 2016;26(3):318-36  Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory...

This article demonstrates that adding a lot of patients without disease and with low test results to a study may improve the ROC curve significantly without any improvement in sensitivity or in positive predictive value of the parameter evaluated. The precision-recall curves are not impacted by the addition of...

Bacterial infections are one of the major reasons for patients presenting to the ED - and the main cause of death in elderly patients. It is important to identify elderly patients with bacterial infections early and initiate treatment in the ED for a better outcome. However, an infection in an elderly patient can be...

This first of two articles on method comparison studies gives some key concepts related to the design of the method comparison study, data analysis and graphical presentation, stressing the importance of a well-designed and carefully planned experiment using adequate statistical procedures for data analysis when...