Harnessing artificial intelligence for enhanced veterinary diagnostics: A look to quality assurance, Part II External validation.

Artificial intelligence (AI) is emerging as a valuable diagnostic tool in veterinary medicine, offering affordable and accessible tests that can match or even exceed the performance of medical professionals in similar tasks. Despite the promising outcomes of using AI systems (AIS) as highly accurate diagnostic tools, the field of quality assurance in AIS is still in its early stages. Our Part I manuscript focused on the development and technical validation of an AIS.

Harnessing artificial intelligence for enhanced veterinary diagnostics: A look to quality assurance, Part I Model development.

Artificial intelligence (AI) has transformative potential in veterinary pathology in tasks ranging from cell enumeration and cancer detection to prognosis forecasting, virtual staining techniques, and individually tailored treatment plans. Preclinical testing and validation of AI systems (AIS) are critical to ensure diagnostic safety, efficacy, and dependability. In this two-part series, challenges such as the AI chasm (ie, the discrepancy between the AIS model performance in research settings and real-world applications) and ethical considerations (data privacy, algorithmic bias) are reviewed and underscore the importance of tailored quality assurance measures that address the nuances of AI in veterinary pathology.

Initial development of a rapid, portable, stall-side ELISA for the measurement of equine adrenocorticotropic hormone.

Pituitary pars intermedia dysfunction (PPID) is a neurodegenerative disease of senior horses. Loss of dopaminergic inhibition of the melanotropes of the pars intermedia leads to increased concentrations of pro-opiomelanocortin (POMC)-derived peptides. Diagnosis is challenging due to pre-analytical variables, such as sample storage, handling, and time to analysis.

Impact of regression modeling on the assessment and harmonization of a point-of-care analyzer and commercial laboratory analyzer for feline plasma biochemistry testing.

Background: Regression describes the relationship of results from two analyzers, and the generated equation can be used to harmonize results. Point-of-care (POC) analyzers cannot be calibrated by the end user, so regression offers an opportunity for calculated harmonization. Harmonization (uniformity) of laboratory results facilitates the use of common reference intervals and medical decision thresholds.

Repeat patient Testing-Quality control: An example of implementation in a network of commercial laboratories.

The theory and calculations underpinning Repeat Patient Testing-Quality Control (RPT-QC) have been presented in prior publications. This paper gives an example of the process used for implementing RPT-QC in a network of veterinary commercial reference laboratories and the stages associated with the transition to the sole use of RPT-QC. To employ RPT-QC in this commercial laboratory network, eight stages of implementation were identified: (1) education, (2) data collection, (3) calculations, (4) QC recording and documentation, (5) running RPT-QC in parallel with a commercially available quality control material (QCM), (6) development of a Standard Operating Procedure (SOP), (7) development of complementary aspects supporting RPT-QC, and (8) sole use of RPT-QC.

Impact on result interpretation of correct and incorrect selection of veterinary glucometer canine and feline settings.

Veterinary glucometers should be correctly coded for the patient species; however, coding errors occur in clinical settings and the impact of such errors has not been characterized. We compared glucose concentrations in 127 canine and 37 feline samples using both canine and feline settings on a veterinary glucometer (AlphaTrak; Zoetis). All samples were measured first on the canine setting and then measured using the feline setting.

Bilateral Cubital Lymphoma and Mycobacteriosis in a Salmon-Crested Cockatoo ().

A 32-year-old male salmon-crested cockatoo () was diagnosed by cytology with bilateral cubital lymphoma and mycobacteriosis. Polymerase chain reaction assay testing confirmed . This patient was subsequently humanely euthanized.

Initial investigation of molecular phenotypes of airway mast cells and cytokine profiles in equine asthma.

Equine asthma is a naturally occurring lung disease characterized by chronic, partially reversible airway obstruction, pulmonary remodeling, and lower airway inflammation. Asthma is currently divided into two major groups, mild to moderate asthma (mEA) and severe asthma (sEA), but further subtyping by phenotype (i.e.

Guidelines for resident training in veterinary clinical pathology. IV: Laboratory quality management-Teaching domains, competencies, and suggested learning outcomes.

Background: The 2019 ASVCP Education Committee Forum for Discussion, presented at the annual ASVCP/ACVP meeting, identified a need to develop recommendations for teaching laboratory quality management principles in veterinary clinical pathology residency training programs.

Objectives: To present a competency-based framework for teaching laboratory quality management principles in veterinary clinical pathology residency training programs, including entrustable professional activities (EPAs), domains of competence, individual competencies, and learning outcomes.

Methods: A joint subcommittee of the ASVCP Quality Assurance and Laboratory Standards (QALS) and Education Committees executed this project.

Analytical quality performance goals for symmetric dimethylarginine in cats.

Background: Symmetric dimethylarginine (SDMA) reflects the glomerular filtration rate (GFR) in people, dogs, and cats. Initial assays used a liquid chromatography-mass spectroscopy (LC) technique. A veterinary immunoassay has been developed for use in commercial laboratories and point-of-care (POC) laboratory equipment.

Repeat patient testing-based quality control shows promise for use in veterinary biochemistry testing.

Background: Repeat patient testing-based quality control (RPT-QC) is a form of statistical QC and an alternative to commercial quality control materials (QCM).

Objective: This study investigated the suitability of canine heparinized plasma for use in RPT-QC and assessed the predicted performance of RPT-QC for the detection of analytical error in chemistry testing.

Methods: The stability of canine plasma for RPT-QC was investigated via storage at two temperatures for three or six time points.

Current and emerging concepts in biological and analytical variation applied in clinical practice.

A single laboratory result actually represents a range of possible values, and a given laboratory result is impacted not just by the presence or absence of disease, but also by biological variation of the measurand in question and analytical variation of the equipment used to make the measurement. Biological variation refers to variability in measurand concentration or activity around a homeostatic set point. Knowledge of biological and analytical variation can be used to facilitate interpretation of patient clinicopathologic data and is particularly useful for interpreting serial patient data and data at or near reference limits or clinical decision thresholds.

Cortisol, progesterone, 17α-hydroxyprogesterone, and TSH responses in dogs injected with low-dose lipopolysaccharide.

Background: Stress and diseases such as endotoxemia induce cortisol synthesis through a complex biosynthetic pathway involving intermediates (progesterone, and 17α-hydroxyprogesterone (17α-OHP)) and suppression of the hypothalamus-pituitary-thyroid axis.

Objective: To measure plasma concentrations of cortisol, progesterone, 17α-OHP, and thyroid stimulating hormone (TSH) in dogs experimentally injected with intravenous low-dose lipopolysaccharide (LPS). Our hypothesis was that LPS treatment would elicit a significant increase in cortisol and its precursors, and a significant decrease in TSH concentration.

Evaluation of automated erythrocyte methodology in new world camelids using the ADVIA 2120 hematology analyzer.

Background: Accurate erythrocyte measurements with ADVIA hematology analyzers require isovolumetric cell sphering in one reaction and hemolysis in another. However, camelid erythrocytes are resistant to sphering and osmotic lysis, and no published evaluation of ADVIA methods for camelids exists.

Objectives: The objectives were to demonstrate whether camelid erythrocytes sphere in the ADVIA red blood cell/platelet (RBC/PLT) reagent and lyse in the ADVIA cyanide HGB reagent, and to determine optimal ADVIA settings for camelids.

Analytic performance evaluation of a veterinary-specific ELISA for measurement of serum cortisol concentrations of dogs.

OBJECTIVE To investigate the precision of an ELISA for measurement of serum cortisol concentration (SCC) in dogs, assess agreement between this ELISA and 2 validated chemiluminescence assays (CLAs), and evaluate the clinical implications of any bias associated with this ELISA when measuring SCC in dogs. DESIGN Evaluation study. SAMPLE 75 stored, frozen serum samples from client-owned dogs.

Analytical quality goals-a review.

Analytical quality goals indicate how laboratory tests must perform to be clinically useful for their intended purpose. These goals have historically focused on analytical error assessment for quantitative methods and vary with measurand concentration or activity, and species. Although formalized quality goal models have been developed in human medicine, quality goals in veterinary medicine, to date, have not been formalized; use of human regulatory-based goals, consensus-based goals, or biologic variation-based goals have been reported most often.

Verification of the Heska Element Point-of-Care blood gas instrument for use with venous blood from alpacas and llamas, with determination of reference intervals.

Background: The Heska Element POC ("EPOC") is a blood gas instrument intended for use with canine, feline, and equine whole blood; no verification for use with camelid specimens has been reported.

Objectives: Using camelid specimens and commercial quality control materials (QCM), we investigatee EPOC analytical performance and establish EPOC camelid reference intervals (RIs).

Methods: Camelid blood (n = 124) was analyzed using the EPOC (pH, pCO , pO , HCO , base excess, SO , sodium, potassium, chloride, ionized calcium, TCO , anion gap, HCT, HGB, glucose, lactate, and creatinine); plasma was analyzed using a Roche Cobas c501 (sodium, potassium, chloride, TCO , anion gap, glucose, and creatinine).

Repeat patient testing shows promise as a quality control method for veterinary hematology testing.

Background: Repeat patient testing-based quality control (RPT-QC) is a potential method for veterinary laboratories (eg, that have a limited budget for quality commercial control material [QCM] or that wish to use material with a species-specific matrix).

Objectives: To determine whether total error (TE ), probability of error detection (Ped), and probability of false rejection (Pfr) similar to that achievable with QC materials can be controlled using RPT-QC METHODS: Control limits (WBC, RBC, HGB, HCT, MCV, and PLT) for the Advia 120 (n = 23) and scil Vet ABC (n = 22) were calculated using data from normal canine specimens from a routine caseload. Specimens were measured at accession and again after 24 hours.

ASVCP guidelines: Allowable total error hematology.

The purpose of this document is to provide total allowable error (TE ) recommendations for commonly analyzed hematology measurands for veterinary personnel. These guidelines define relevant terminology and highlight considerations specific to hematology measurands. They also provide reasons and guidelines for using TE in instrument performance evaluation, including recommendations for when the total observed error exceeds the recommended TE .