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Inconsistencies in sweat testing in UK laboratories
1Department of Paediatric Biochemistry, Royal Hospital for Sick Children, Edinburgh, Scotland, UK. Jean.M.Kirk@btinternet.com
Archives of Disease in Childhood
|May 9, 2000
Summary
Sweat testing shows significant variability in collection, analysis, and interpretation across centers. Standardization through national guidelines and quality assessment is needed to improve diagnostic accuracy.
Area of Science:
- Clinical Chemistry
- Pediatric Diagnostics
- Medical Laboratory Science
Background:
- Sweat testing procedures are widely perceived to exhibit considerable variability.
- This variability impacts the reliability and comparability of diagnostic results.
Purpose of the Study:
- To evaluate the extent of variability in sweat collection, analysis, and interpretation methods.
- To identify specific areas of divergence in current sweat testing practices.
Main Methods:
- A questionnaire was distributed to 30 self-selected centers (15 pediatric, 15 general hospitals).
- Data collected focused on sweat collection techniques, analysis parameters, and interpretation criteria.
Main Results:
- Significant variations observed in test volume, diagnostic rates, minimum test age, pilocarpine iontophoresis parameters, and sweat collection methods (filter paper vs. Macroduct).
- Reported adverse skin reactions included urticaria, redness, blistering, and burns.
- Inconsistencies noted in sweat analysis (sodium, chloride, osmolality, conductivity) and the use of reference ranges.
- A notable percentage of tests (2-25%) were deemed insufficient, and some centers excluded children with severe eczema.
Conclusions:
- Local audits are essential to enhance performance and identify areas for improvement.
- Development of national guidelines is recommended to standardize sweat collection and analysis.
- Implementation of external quality assessment programs is crucial for providing analytical feedback and improving overall testing quality.