Chemistry, Immunochemistry, Test Utilization

Beta CTX Update

On March 21, 2017, Spectrum Health Regional Laboratory (SHRL) will be switching instrument/vendors that perform the Beta CTX (BCTX assay); we will be switching from the ROCHE COBAS® platform to the ISYS-IDS platform.  Both methods compare very well, however reference ranges will change due to the different methods.

  Current Reference Range NEW REFERENCE RANGE Unit
Male <18 years:   Not Established 
>18-30 years:   160-800 
>50-70 years:   40-840 
>70 years:   Not Established
38-724 pg/mL
Female <18 years: Not Established
Premenopausal: 30-570 
Postmenopausal: 100-1010  
 Premenopausal:    34-635
Postmenopausal:   34-1037
pg/mL

TEST INFORMATION:

Due to this change, #9221 Beta CTx Blood Level test  will be discontinued.

New Test: #7162 Beta CTx-1 (Cross Laps)

Consequently, for a six month period, post go live, SHRL will offer the opportunity for ordering providers to re-baseline existing patients. Re-baselining will consist of the following:

A) Ordering the test and indicating  that re-baselining is requested.
B) New instrument result will go the EMR chart and for comparison purposes, the old instrument result will be reported as a comment to the new result.

Osteoporosis Bone Markers

With full recognition, that there are other bone markers of formation and resorption noted in the literature and available at other institutions; we also note that the literature and current osteoporosis guidelines/recommendations are not clear as to which is the best marker of formation and resorption. Additionally, the current guidelines/recommendations are not clear about the appropriate use of these makers. Please consider use of the osteoporosis tests offered in house at Spectrum Health Regional Laboratory so that we can all be better stewards of appropriate and cost efficient medical care. If you have been historically following a patient on one of the markers that is sent out (NTX blood or PINP), we will gladly work with you to re-baseline your patients at no additional charge to the patient.

Thank you for your consideration. Any questions concerning this change may be directed to Dr. David Alter via the “Contact Us” link.

Spectrum Health Regional Laboratory offers in-house testing for two osteoporosis related serum bone markers:

Marker of Formation – OSTEOCALCIN (SH#9213)
Marker of Resorption – BETA CTX (SH#7162)

MARKER OF RESORPTION WHERE PERFORMED SPECTRUM HEALTH COST Jan 2016 – Feb 2017 TOTAL COST
N-telopeptide (NTx)   (serum) SENT OUT $135.00 957 $129,195
C-telopeptide (CTx) Spectrum Health $2.00/test 2796 $5,592
MARKER OF FORMATION
Osteocalcin Spectrum Health $13.00/test 49 $637
Procollagen amino terminal  extension peptide (P1NP) SENT OUT $179.92 3412 $613,887.04

 

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