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The quality of laboratory aspects of troponin testing in clinical practice guidelines and consensus documents needs

Kristin M Aakre1, Michel R Langlois2, Julian H Barth3

  • 1Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway; The Norwegian Clinical Chemistry EQA Program, Bergen, Norway; The European Federation of Clinical Chemistry and Laboratory Medicine and European Union of Medical Specialists joint working group on Guidelines.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|July 19, 2014
PubMed

Insights

Clinical practice guidelines often lack standardized information on troponin testing for acute coronary syndrome diagnosis. This study highlights the need for updated guidelines addressing analytical and biological issues in troponin assays.

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Cardiology

Background:

  • Standardizing laboratory test descriptions in clinical practice guidelines (CPGs) is crucial for consistent patient care.
  • The European Federation of Laboratory Medicine (EFLM) and Union of European Medical Specialists (UEMS) proposed a checklist for this purpose.

Purpose of the Study:

  • To evaluate existing CPGs for chest pain and acute coronary syndrome diagnosis against the EFLM-UEMS checklist.
  • To identify gaps and inconsistencies in the reporting of troponin assays within these guidelines.

Main Methods:

  • A systematic review of nine CPGs or consensus documents published between 2011 and 2013.
  • Evaluation of these documents using the standardized checklist for laboratory investigations.

Main Results:

  • CPGs frequently discuss troponin testing for acute coronary syndrome but provide variable and vague information.
  • Key checklist items are often omitted or outdated, particularly regarding analytical quality goals for high-sensitivity assays and potential interferences.
  • Inconsistencies can lead to diagnostic uncertainty.

Conclusions:

  • Current CPGs require updates to accurately reflect analytical and biological aspects of troponin assays.
  • Recommendations are provided for improved analytical quality goals to enhance diagnostic accuracy in CPGs.
Abstract

Keywords:
Acute coronary syndromeAnalytical qualityGuidelineInterferenceTroponin

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