Evaluation of quantitative cardiac biomarker point-of-care testing in the emergency department.

This study was undertaken to evaluate the diagnostic accuracy and practicality of Emergency Department (ED) testing for cardiac biomarkers in the diagnosis of acute coronary syndromes. All patients presenting with chest pain to the ED of a community-based tertiary care facility over a 16-day period (N = 205) had blood drawn and tested for cardiac troponin I, myoglobin, and CK-MB by a quantitative, point-of-care instrument system (Stratus CS). Point-of-care cardiac testing expedited diagnosis by decreasing the turn-around time by 55% compared to the central laboratory.

Long-term experience with an accelerated protocol for diagnosis of chest pain.

Context: More than 6 million patients present annually with chest pain suggestive of acute coronary syndrome. Rapid and accurate diagnosis is essential for best clinical outcomes, for optimal management of hospital resources, and for minimizing medicolegal exposure.

Objective: To evaluate the clinical and cost outcomes of an accelerated protocol for chest pain triage in a community-based hospital of moderate size.

An evaluation of ethylene glycol-based liquid specimens for use in quality control.

We investigated the analytical acceptability of ethylene glycol-based control sera by preparing sets of aqueous and ethylene glycol-based specimens that had added uric acid, calcium, creatinine, glucose, urea, sodium, and potassium. Ethylene glycol caused a significant systematic proportional bias in procedures involving dialysis, but had no discernible effect on methods not involving dialysis. The extent of bias was proportional to the concentration of ethylene glycol, was independent of protein concentration, and differed according to the type of dialysis system used.

Performance evaluation of multi-channel analyzers by use of linearly-related survey specimens.

Sets of specimens having quantitative linear inter-relationships for 25 analytes were prepared and used in a small survey of results with multi-channel analyzers. Instrument calibration was evaluated by linear regression analysis of the analytical results, with calculation of the x- and y-intercepts and slopes. The average intercepts and slopes agreed quite well with those expected on the basis of specimen preparation, but the results from individual laboratories and from particular kinds of instruments demonstrated a variety of analytical biases.

Design of quality-control specimens for use with a small multi-channel analyzer.

Specimens having linear relationships between concentration and instrument response for seven analytes were prepared for use with a small multi-channel analyzer. The specimens had inter-specimen and inter-constituent relationships that facilitated the performance evaluation of all channels simultaneously with each individual specimen. Techniques are described for use of the specimens in various aspects of quality control.