BACKGROUND: False-positive cardiac troponin (Tn) results caused by outliers have been reported on various analytical platforms. We have compared the precision profile and outlier rate of the Abbott Diagnostics contemporary troponin I (TnI) assay with their high sensitivity (hs) TnI assay. METHODS: Three studies were conducted over a 10-month period using routine patients' samples. TnI was measured in duplicate using the contemporary TnI assay in Study 1 and Study 2 (n = 7011 and 7089) and the hs-TnI assay in Study 3 (n = 1522). Critical outliers were defined as duplicate results whose absolute difference exceeded a critical difference (CD = z x √2 x SDAnalytical) at a probability level of 0.0005, with one of the results on the opposite side of the decision limit to its partner. RESULTS: The TnI concentration at 10% imprecision (coefficient of variation) for the contemporary TnI assay was 0.034 µg/L (Study 1) and 0.042 µg/L (Study 2), and 0.006 µg/L (6 ng/L) for the hs-TnI assay. The critical outlier rates for the contemporary TnI assay were 0.51% (Study 1) and 0.37% (Study 2) using a cut-off of 0.04 µg/L, and 0% for the hs-TnI assay using gender-specific cut-offs. CONCLUSION: The significant number of critical outliers detected using the contemporary TnI assay may pose a risk for misclassification of patients. By contrast, no critical outliers were detected using the hs-TnI assay. However, the total outlier rates for both assays were significantly higher than the expected variability of either assay. The cause of these outliers remains unclear.
BACKGROUND: False-positive cardiac troponin (Tn) results caused by outliers have been reported on various analytical platforms. We have compared the precision profile and outlier rate of the Abbott Diagnostics contemporary troponin I (TnI) assay with their high sensitivity (hs) TnI assay. METHODS: Three studies were conducted over a 10-month period using routine patients' samples. TnI was measured in duplicate using the contemporary TnI assay in Study 1 and Study 2 (n = 7011 and 7089) and the hs-TnI assay in Study 3 (n = 1522). Critical outliers were defined as duplicate results whose absolute difference exceeded a critical difference (CD = z x √2 x SDAnalytical) at a probability level of 0.0005, with one of the results on the opposite side of the decision limit to its partner. RESULTS: The TnI concentration at 10% imprecision (coefficient of variation) for the contemporary TnI assay was 0.034 µg/L (Study 1) and 0.042 µg/L (Study 2), and 0.006 µg/L (6 ng/L) for the hs-TnI assay. The critical outlier rates for the contemporary TnI assay were 0.51% (Study 1) and 0.37% (Study 2) using a cut-off of 0.04 µg/L, and 0% for the hs-TnI assay using gender-specific cut-offs. CONCLUSION: The significant number of critical outliers detected using the contemporary TnI assay may pose a risk for misclassification of patients. By contrast, no critical outliers were detected using the hs-TnI assay. However, the total outlier rates for both assays were significantly higher than the expected variability of either assay. The cause of these outliers remains unclear.
Authors: Paul Welsh; David Preiss; Anoop S V Shah; David McAllister; Andrew Briggs; Charles Boachie; Alex McConnachie; Caroline Hayward; Sandosh Padmanabhan; Claire Welsh; Mark Woodward; Archie Campbell; David Porteous; Nicholas L Mills; Naveed Sattar Journal: Clin Chem Date: 2018-08-20 Impact factor: 8.327
Authors: Stefanie Neubig; Anne Grotevendt; Anders Kallner; Matthias Nauck; Astrid Petersmann Journal: Biochem Med (Zagreb) Date: 2017-02-15 Impact factor: 2.313
Authors: Nick S R Lan; Damon A Bell; Kieran A McCaul; Samuel D Vasikaran; Bu B Yeap; Paul E Norman; Osvaldo P Almeida; Jonathan Golledge; Graeme J Hankey; Leon Flicker Journal: J Am Heart Assoc Date: 2019-03-05 Impact factor: 5.501
Authors: Graham R Lee; Tara Ca Browne; Berna Guest; Imran Khan; Eamon Murphy; Catherine McGorrian; Niall G Mahon; Maria C Fitzgibbon Journal: Pract Lab Med Date: 2016-01-13