A new parameter called critical reference change value (CrRCV) to be applied for the interpretation of serial measurements of cardiac troponin I (cTnI) is introduced. To illustrate the practical utility of CrRCV a set of clinical examples based on two consecutive cTnI results are presented. Thus three cTnI changes...

Various guidelines and recommendations are available for the use of natriuretic peptides in the diagnosis of heart failure. As it is known that old age may lead to higher natriuretic peptide values in the absence of heart failure, it is relevant to decide whether to use age-dependent reference intervals for clinical...

ROC curves are frequently used to show in a graphical way the connection/trade-off between clinical sensitivity and specificity for every possible cut-off for a test or a combination of tests. In addition the area under the ROC curve gives an idea about the benefit of using the test(s) in question.  ROC curves are...

PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward. DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward. FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...

The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2. Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT). More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...

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.   ...

Mock inspections are a great way to prepare for real-life inspections from regulatory agencies such as CAP and JCAHO. But where do you start? And most importantly, what should you look for? Lou Ann Wyer, Clinical Specialist, POCT at the Virginia-based Sentara Laboratory Services and Theresa Kulik, Point-of-care...

Reprinted with permission from British Journal of Nursing, 2004, Vol 13, No 9.  Arterial puncture is the most common method used to obtain a sample for the measurement of arterial blood gases (ABGs) and is essential to guide the prescription of long-term oxygen therapy (LTOT) in patients with chronic hypoxic lung...

As point-of-care testing (POCT) continues to expand in the hospital environment, the desire of physicians to participate in the performance of testing may increase. This article discusses the required competencies for a physician who wishes to be involved in laboratory testing and some practical considerations for...

Effectively written policies and procedures can help contribute to an error-free POCT program. Sentara Healthcare has incorporated policy and procedure development into their safety program. It is coined Focus & Simplify and is about improving the effectiveness of work processes and procedure documentation.  Through ...