Abstract

Background Laboratory professionals should independently verify the correct implementation of metrological traceability of commercial measuring systems and determine if their performance is fit for purpose. We evaluated the trueness, uncertainty of measurements, and transferability of six clinically important enzyme measurements (alanine aminotransferase [ALT], alkaline phosphatase [ALP], aspartate aminotransferase [AST], creatine kinase [CK], γ-glutamyltransferase [γGT], and lactate dehydrogenase [LDH]) performed on the Abbott Alinity c analytical system. Methods Target values and associated uncertainties were assigned to three pools for each enzyme by using the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) reference measurement procedures (RMPs) and the pools were then measured on the Alinity system. Bias estimation and regression studies were performed, and the uncertainty associated with Alinity measurements was also estimated, using analytical performance specifications (APS) derived from biological variability of measurands as goals. Finally, to validate the transferability of the obtained results, a comparison study between two Alinity systems located in Milan, Italy, and Bydgoszcz, Poland, was carried out. Results Correct implementation of traceability to the IFCC RMPs and acceptable measurement uncertainty fulfilling desirable (ALP, AST, LDH) or optimal APS (ALT, CK, γGT) was verified for all evaluated enzymes. An optimal alignment between the two Alinity systems located in Milan and Bydgoszcz was also found for all enzyme measurements. Conclusions We confirmed that measurements of ALT, ALP, AST, CK, γGT, and LDH performed on the Alinity c analytical system are correctly standardized to the IFCC reference measurement systems and the system alignment is consistent between different platforms.

Highlights

  • Serum enzymes are important biomarkers for the diagnosis and management of many organ-related diseases and are among the most requested tests in medical laboratories [1]

  • Phone: +39 02 39042683, Fax: +39 02 39042896, E-mail: elena.aloisio@unimi.it Erika Frusciante, Sara Pasqualetti, Ilenia Infusino and Mauro Panteghini: Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy Magdalena Krintus and Grazyna Sypniewska: Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland alignment between the two Alinity systems located in Milan and Bydgoszcz was found for all enzyme measurements

  • We considered enzyme results obtained on the two platforms negligibly biased and, the Alinity measuring system (MS) standardization to IFCC reference measurement procedures (RMPs), shown for the Milan system, was considered perfectly transferable to the Bydgoszcz platform

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Summary

Introduction

Serum enzymes are important biomarkers for the diagnosis and management of many organ-related diseases and are among the most requested tests in medical laboratories [1]. Standardization in clinical enzymology is essential in order to provide global equivalence of results in clinical samples, independently of the employed measuring system (MS) [2, 3] To pursue this objective, the ‘reference system’ approach, based on the concepts of metrological traceability and a hierarchy of measurement procedures, should be applied [4]. To fulfil the European Union 1998/79 Directive and the new 2017/746 Regulation on in vitro diagnostics (IVD) medical devices, manufacturers should align their commercial MS to these RMPs [8] This will permit to obtain equivalent results in clinical samples, independently of the employed MS and the individual laboratory where measurements are carried out. Results: Correct implementation of traceability to the IFCC RMPs and acceptable measurement uncertainty fulfilling desirable (ALP, AST, LDH) or optimal APS (ALT, CK, γGT) was verified for all evaluated enzymes.

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