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Licensed Unlicensed Requires Authentication Published by De Gruyter October 30, 2010

Standardization activities in the field of thyroid function tests: a status report

Linda M. Thienpont , Katleen Van Uytfanghe , Sofie Van Houcke and on behalf of the IFCC Working Group for Standardization of Thyroid Function Tests (WG-STFT)


Background: Laboratory testing is an essential tool for diagnosis and management of thyroid diseases. However, the current status of standardization hampers the interchangeability of results. To improve this situation, the Working Group for Standardization of Thyroid Function Tests was established.

Methods: Method comparisons were organized for measurement of human thyroid stimulating hormone (TSH), and free and total thyroid hormone in serum from apparently healthy donors. The aim was to assess the status of standardization and the quality of the performance of current routine assays. A second objective was to investigate the effect of mathematical recalibration of the results using their relationship to the overall mean (TSH) or the reference measurement procedure values (other thyroid hormones).

Results: The need for standardization was shown to be highest for free thyroid hormone and total triiodothyronine measurements, while the majority of TSH and total thyroxine assays agreed within 10% of the reference. Most assays showed good performance. However, some could benefit from improved precision, consistency of calibration, or within- and between-run stability. Recalibration eliminated assay-specific bias. Thus, the residual spread was due to within-method effects. Not withstanding, sample-related effects remained.

Conclusions: These studies confirmed the feasibility of standardization based on method comparison with native sera, but highlighted the need to resolve issues, such as sample-related effects. In view of the fact that in this phase the project worked with samples from individuals with euthyroid status, the next method comparison shall place emphasis on challenging the performance of the assays with clinical samples and expanding the covered measurement range.

Clin Chem Lab Med 2010;48:1577–83.

Corresponding author: Linda M. Thienpont, Laboratory for Analytical Chemistry, Faculty of Pharmaceutical Sciences, Ghent University, Harelbekestraat 72, Ghent 9000, Belgium Phone: +32-9-264-81-04, Fax: +32-9-264-81-98,

Published Online: 2010-10-30
Published in Print: 2010-11-01

©2010 by Walter de Gruyter Berlin New York

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