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Related Experiment Videos

Should we still be doing duplicate immunoassays?

E Lester1, C Corns

  • 1Department of Chemical Pathology, North Middlesex Hospital, London.

Journal of Clinical Pathology
|September 1, 1988
PubMed
Summary
This summary is machine-generated.

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Reassessing duplicate radioimmunoassay testing reveals that while minor discrepancies exist, they rarely impact clinical decisions or patient care. The cost of routine duplication outweighs the minimal clinical benefit in most laboratory assays.

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Endocrinology

Background:

  • Advancements in radioimmunoassay (RIA) techniques may reduce the necessity for duplicate testing.
  • Routine duplication of laboratory assays incurs significant financial costs.
  • The clinical relevance of minor discrepancies in RIA results requires evaluation.

Purpose of the Study:

  • To retrospectively analyze the necessity of duplicate radioimmunoassay testing in routine diagnostics.
  • To quantify the frequency and clinical impact of discrepancies between duplicate assay results.

Main Methods:

  • Retrospective analysis of routine radioimmunoassay results over one month.
  • Examination of differences exceeding 10% between duplicate assays for various hormones.

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  • Assessment of the potential clinical impact of result discrepancies on patient management.

    • Main Results:

    • Discrepancies over 10% were observed in 4-15% of assays for thyroid stimulating hormone, total thyroxine, cortisol, follicular stimulating hormone, and luteinising hormone.
    • No significant discrepancies were found for alpha fetoprotein assays.
    • Only a very small fraction (0.26%) of thyroid stimulating hormone duplicates could have led to different clinical actions; no other assay differences caused potential misclassification.

    Conclusions:

    • While assay replication improves scientific accuracy, the clinical significance of these improvements is often minimal.
    • The financial cost associated with routine duplicate radioimmunoassay testing is considerable and rarely justified by clinical impact.
    • Current radioimmunoassay techniques may render routine duplication unnecessary for most diagnostic assays.