Ultrasensitive troponin and lab reports

February 22, 2014

heart

I attended an NEAACC meeting which featured the pathologist Petr Jarolim speaking about troponin. Since I haven’t followed troponin for a few years, I was humbled to learn how fast things have changed. For example, for ultrasensitive troponin assays:

  • 100% of healthy subjects have a measureable troponin
  • The higher the troponin value, the more likely a cardiac event, even for values below the cutoff

This led to a question from the audience, should healthy people get a baseline troponin value. The speaker is a pathologist not a clinician but he thought this was a good idea and he has his baseline value.

This raises an issue about lab reports, which typically do not list the manufacturer of the assay. But for an assay such as troponin, if one got serial results over the years and didn’t know if the results were from one manufacturer, the results might be hard to interpret. Maybe healthy people will get serial troponin values, maybe not, but the same lab report problem exists for all assays. The manufacturer/test method should be listed on the lab report.


Clinicians and measurement uncertainty

February 15, 2014

Young, smiling female doctor in a white coat.

I was reading a paper, which started out by saying that measurement uncertainty estimates are used by clinicians to help them to interpret results. Now this type of general introductory statement is common in papers that then go off onto the meat of the paper, which in this case didn’t have anything to do with clinicians.

In any case, I have never seen a lab report that provides measurement uncertainty estimates and I believe that clinicians pretty much believe lab results as is and would not use measurement uncertainty estimates, were they provided. Does anyone know of clinicians who use measurement uncertainty estimates?


New Publication

February 10, 2014

article

In my ongoing battle with authors who advocate an incomplete total error model for glucose meters (used in diabetes), my latest contribution is here. The link provides the abstract but the full paper seems also to be available without a subscription, at least for now.