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The diagnosis of pulmonary embolism is challenging due to the non-specificity of signs and symptoms and the very busy Emergency Departments to which the overall majority of patients with suspected PE present. While several well-validated diagnostic algorithms exist and are readily available, it is known that in many...

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...

Procalcitonin (PCT) is a biomarker which is elevated in bacterial infection. Usefulness of PCT measurements in community-acquired pneumonia (CAP) has to be proven by many studies. A single measurement of PCT on admission or outpatient visits is useful to diagnose CAP, estimate causative pathogens pattern, and for...

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...

When a new D-dimer method is evaluated, it’s typically compared to an established D-dimer method using both an analytical and a clinical comparison. Analytical comparisons should be discouraged, as they do not give any useful information about the potential clinical usability of the assay. D-dimer assay comparisons...