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Related Experiment Videos

Inaccuracies in digoxin measurement.

J D Cook1, T R Koch, M S Cook

  • 1Department of Pathology, University of Maryland School of Medicine, Baltimore 21201.

Clinical Biochemistry
|December 1, 1988
PubMed
Summary

This study evaluated six digoxin immunoassay kits for accuracy and interference from digoxin-like immunoreactive substance (DLIS). Results show significant variations in digoxin measurement accuracy and DLIS interference across different kits, impacting patient results.

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Area of Science:

  • Clinical Chemistry
  • Immunoassay Technology
  • Pharmacology

Background:

  • Digoxin is a critical medication for heart conditions, requiring accurate measurement.
  • Digoxin immunoassays are susceptible to interference from digoxin-like immunoreactive substances (DLIS).
  • Variations in assay performance can lead to misinterpretation of patient digoxin levels.

Purpose of the Study:

  • To evaluate the calibration accuracy of six commercial digoxin immunoassay kits.
  • To assess the extent of interference by digoxin-like immunoreactive substances (DLIS) in these kits.
  • To inform clinical interpretation of digoxin results based on kit performance.

Main Methods:

  • Six commercial digoxin immunoassay kits were tested using digoxin reference standards in pooled human serum.

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  • Sera from patient populations with potential DLIS (pregnant women, newborns, hypertensives, uremics) were analyzed.
  • Statistical analysis (p < 0.05) was used to identify significant differences from healthy controls.

    • Main Results:

    • Abbott and Becton Dickinson kits underestimated digoxin concentrations, while others overestimated.
    • Bias magnitude generally increased with digoxin concentration.
    • Significant DLIS interference was observed in newborns and pregnant women for Abbott, Becton Dickinson, Dupont, Kallestad, and Syva kits.

    Conclusions:

    • Commercial digoxin immunoassay kits exhibit varying calibration accuracy and susceptibility to DLIS interference.
    • Specific kits showed significant interference in patient populations like newborns and pregnant women.
    • Clinicians must be aware of individual kit limitations for accurate digoxin level interpretation.