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Interconversion of Plasma Free Thyroxine Values from Assay Platforms with Different Reference Intervals Using Linear

Fanwen Meng1, Jacqueline Jonklaas2, Melvin Khee-Shing Leow3,4,5,6

  • 1National Healthcare Group, Department of Health Services and Outcomes Research, 3 Fusionopolis Link, Nexus@One-North, Singapore 138543, Singapore.

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Summary
This summary is machine-generated.

Interpreting thyroid function tests (TFT) across different platforms is challenging. This study introduces linear transformation methods to accurately convert free thyroxine (FT4) values between assay platforms, aiding patient monitoring.

Keywords:
assaysequilibrium dialysisreference intervalsscale transformationthyroid hormones

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Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Thyroid function tests (TFTs), including free thyroxine (FT4) and thyroid-stimulating hormone (TSH), are crucial for diagnosing and monitoring thyroid disorders.
  • Comparing TFT results across different assay platforms with varying reference intervals is problematic due to assay-specific variations.
  • Current methods for interconverting FT4 and TSH values between platforms are often unreliable, complicating longitudinal patient management.

Purpose of the Study:

  • To develop and validate a reliable methodology for interconverting FT4 values between different laboratory assay platforms.
  • To establish a method for scaling FT4 values to a desired reference range using linear transformation techniques.
  • To explore the potential application of these transformation methods for other biochemical analytes, such as TSH.

Main Methods:

  • Simultaneous assaying of FT4 using direct analog immunoassay, tandem mass spectrometry, and equilibrium dialysis as reference methods.
  • Application of linear and piecewise linear transformation models to interconvert FT4 values across different assay scales.
  • Evaluation of the accuracy of transformation methods based on the relative accuracy of the source and target assay platforms.

Main Results:

  • Both linear and piecewise linear transformations demonstrated good accuracy for FT4 inter-scale conversion.
  • Linear transformation was more accurate when converting from a highly accurate assay to a less accurate one.
  • Piecewise linear transformation outperformed linear transformation when converting from a less accurate assay to a more robust one.

Conclusions:

  • Accurate FT4 inter-conversion between assay platforms is achievable using linear transformation methods.
  • The choice between linear and piecewise linear transformation depends on the relative accuracy of the assays involved.
  • This methodology can improve the interpretation of TFT trends in patients with thyroid disorders and may be applicable to other biochemical tests.