Browsing Tag

David Alter

Chemistry, Compliance & Safety, General Information

Reference Range Update: Anti-Thyroid Peroxidase Antibody

As of October 1, 2018, the reference interval for Anti-Thyroid Peroxidase Antibody levels has been updated to 0.0 to 34.9 IU/mL from 0.0 to 8.9 IU/mL. This change is due in part to client feedback resulting in an audit of the existing range and leading to discovery that it had not  been updated when the instrument had been changed.

We appreciate and welcome any and all client feedback; if you identify what may appear to be an incorrect reference interval, please notify us immediately using the “Contact Us” link above.

Chemistry, General Information

Fasting Lipid Test Update

Effective August 8th, Spectrum Health Laboratory will ask all patients to indicate how long they have been fasting (regardless of whether they were fasting or not) when they present for Lipid testing. In light of recent discussions in the literature that debate the utility of fasting prior to lipid testing; we recognize that some clinicians may now not require their patients to be fasting and hope that reporting out length of fasting (hours) with each lipid result will allow all clinicians to better interpret their patient’s lipid results. If fasting is desired; Spectrum Health Laboratory recommends no caloric or caffeine intake for at least 8 hours. The patient is not to drink (other than water), eat, smoke, chew gum, candy, cough drops, etc. for at least 8 hours prior to their blood tests. Prescribed medications are allowed. Continue Reading

Compliance & Safety

Biotin Alert

Biotin is widely used in immunoassay type laboratory methods over a wide range of instruments at numerous clinical laboratories throughout the world (including Spectrum Health).

With the expansion of biotin – also known as vitamin B7 – supplementation and treatments (“over the counter” and prescription, respectively); an associated interference with many clinical laboratory tests has been identified, confirmed and documented. Unfortunately, magnitude and type (falsely increased/decreased) of interference varies with dose and assay; however, it has been confirmed that as dose increases so does the magnitude of the response. In late November 2017, the Food and Drug Administration (FDA) published a safety alert warning that biotin can interfere with certain lab tests and cause incorrect test results. Continue Reading

Referral/Sendouts, Test Utilization

Anti-Thyroglobulin Orders Received in Conjunction with Thyroglobulin Tumor Marker Orders

Effective immediately, Anti-Thyroglobulin (Anti-TgAb) requests if received in conjunction with Thyroglobulin Tumor Marker (Tg-TM) requests, will be canceled. Tg-TM tests are sent to Mayo Medical Laboratory; where both Tg-TM and Anti-TgAb are performed and resulted as part of the Tg-TM order. This is a laboratory best practice as anti-thyroglobulin autoantibodies (Anti-TgAb), which occur in 15% to 30% of thyroid cancer patients, could lead to misleading Tg results (falsely positive or falsely negative).

Questions may be directed to Dr. David Alter, using the “Contact Us” link above.

Compliance & Safety, Toxicology

Urgent Notice: Lead Testing

On May 17, 2017, the US Food and Drug Administration (FDA) issued a safety communication warning against using venous samples on Point of Care Magellan Diagnostics LeadCare Testing System devices (LeadCare, LeadCare II, LeadCare Plus, and LeadCare Ultra). Venous specimens appear to be at risk for having falsely low results.  Only Capillary (“finger stick” or “heel stick”) specimen types should be used.

IF YOUR OFFICE IS USING ANY OF THE MAGELLAN LEADCARE TESTING SYSTEM DEVICES: please DISCONTINUE the use of VENOUS specimens for testing. Continue Reading

Immunochemistry, Test Utilization

Utility of specific IgE (sIgE) testing to foods and food allergen components

The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis. Continue Reading