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...

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...

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...

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...

Clinical sensitivity, clinical specificity and predictive values are frequently used as performance measure for a biochemistry assay. When D-dimer assay performance is presented, emphasis is often on the negative predictive value (NPV). However, predictive values are greatly influenced by the prevalence of the...

Reprinted from Ann Lab Med 2014 Sep; 34(4):263-73. Procalcitonin (PCT) is used as a biomarker for the diagnosis of sepsis, severe sepsis and septic shock. At the same time, PCT has also been used to guide antibiotic therapy. This review outlines the main indications for PCT measurement and points out possible...