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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
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1437-4331
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Volume 47, Issue 11

Issues

Comparison of visual vs. automated detection of lipemic, icteric and hemolyzed specimens: can we rely on a human eye?

Ana-Maria Simundic
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nora Nikolac
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Valentina Ivankovic
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Dragica Ferenec-Ruzic
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Bojana Magdic
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marina Kvaternik
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Elizabeta Topic
  • University Department of Chemistry, School of Medicine, Faculty of Pharmacy and Biochemistry, Zagreb University, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2009-09-25 | DOI: https://doi.org/10.1515/CCLM.2009.306

Abstract

Background: Results from hemolyzed, icteric, and lipemic samples may be inaccurate and can lead to medical errors. These preanalytical interferences may be detected using visual or automated assessment. Visual inspection is time consuming, highly subjective and not standardized. Our aim was to assess the comparability of automated spectrophotometric detection and visual inspection of lipemic, icteric and hemolyzed samples.

Methods: This study was performed on 1727 routine biochemistry serum samples. Automated detection was performed using the Olympus AU2700 analyzer. We assessed: 1) comparability of visual and automated detection of lipemic, icteric and hemolyzed samples, 2) precision of automated detection, and 3) inter-observer variability for visual inspection.

Results: Weighted κ coefficients for comparability of visual and automated detection were: 0.555, 0.529 and 0.638, for lipemic, icteric and hemolyzed samples, respectively. The precision for automated detection was high for all interferences, with the exception of samples being only slightly lipemic. The best overall agreement between observers was present in assessing lipemia (mean weighted κ=0.698), whereas the lowest degree of agreement was observed in assessing icterus (mean weighted κ=0.476).

Conclusions: Visual inspection of lipemic, icteric and hemolyzed samples is highly unreliable and should be replaced by automated systems that report serum indices.

Clin Chem Lab Med 2009;47:1361–5.

Keywords: hemolysis; icteria; interference; lipemia; preanalytical

About the article

Corresponding author: Assist. Prof. Ana-Maria Simundic, PhD, University Department of Chemistry, Department of Molecular Diagnostics, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia


Received: 2009-06-30

Accepted: 2009-07-17

Published Online: 2009-09-25

Published in Print: 2009-11-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 47, Issue 11, Pages 1361–1365, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.306.

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