RESUMO
Detection of myositis autoantibodies (MAs) has utility in both the diagnosis and subtyping of idiopathic inflammatory myopathies (IIMs). Multiplex assays such as the Euroimmun line immunoassay (LIA) have significant limitations in rare diseases like IIM. A retrospective cohort study was performed on positive MA detected on LIA in 171 patients using the manufacturer's recommended cut-off. Only 16.7% were deemed true positive after clinical correlation. Autoantibody-specific cut-offs were created and applied to the original cohort, along with generically applied higher cut-offs. Positive predictive value (PPV) improved, but there was variable increase in false negatives. False positive MA results are common using LIA, but locally derived cut-offs can improve performance. Clinicians must be aware of the limitations of LIA, which is the commonest method for MA detection in Australasia.
Assuntos
Autoanticorpos , Miosite , Humanos , Estudos Retrospectivos , Miosite/diagnóstico , Imunoensaio , Valor Preditivo dos TestesRESUMO
We compared the performance of cobas 4800 PCR for Neisseria gonorrhoeae with culture and found an association between pipetting errors and positive culture, caused by mucopurulent discharge. The problem may be resolved by pretreating samples with Sputasol, thus improving detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.
Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Gonorreia/diagnóstico , Muco , Neisseria gonorrhoeae/isolamento & purificação , Reação em Cadeia da Polimerase , Chlamydia trachomatis/genética , Feminino , Amplificação de Genes , Humanos , Masculino , Neisseria gonorrhoeae/genética , Nova Zelândia , Reação em Cadeia da Polimerase/métodos , Kit de Reagentes para Diagnóstico , Sensibilidade e EspecificidadeRESUMO
Over-utilisation of pathology requests can incur unnecessary costs and be detrimental to patient care. The choosing wisely campaign has helped to reduce the use of tests with limited or no value. This report describes the estimated benefits and costs of implementing a triage process of infectious serology requests in a single mixed hospital and community laboratory. Data analysis of triaging of send away infectious serology was conducted from 1 November 2016 to 31 October 2017. A total of 618 tests were triaged over a 1-year period. Of these 379 (61.3%) were declined. The total gross savings was $45,066. The total cost for implementing this change was estimated to be $4220 per year. The total saving was $40,846.37. There was significant cost saving secondary to this intervention, with other more difficult to measure tangible benefits including fostering communication between laboratory staff and clinicians.