Heavy Chain Disease Can Be Detected by Capillary

Introduction of spectrophotometric detection of serum indices and decision rules to be carried out manually increased the detection rate of relevant hemolysis 6.04- fold. After introduction of the algorithm in the LIS, the detection rate for relevant serum interference was 69.37- fold higher than in the first 1-year period. For icteric samples, a large increase in reported interference was observed: whereas the occurrence of icterus in the sample was not reported at all in the first period, during the second 1-year period, 0.05% of specimens were reported as significantly icteric, causing deviations in the assay results. This number was increased 10-fold (0.54%) in the third period. Interestingly, only one case of lipemia was reported in the first period and none in the second period. Appar- ently, automated spectrophotometric detection together with written instructions in the second 1-year period did not lead to adequate reporting to the clinician. In the third year, 1012-fold more cases of clinically relevant lipemia were reported than in the first year. It should be pointed out here that the evaluation performed and the observed quality improvement depend on the validity of the auto- mated procedure. Summarizing, we believe that this algorithm can be used as a blueprint for processing of test results in general. Every test result is now evaluated automatically in real time against predetermined tolerance limits for the extent of interfering substances, and the algorithm is designed as an almost technician-independent method. We encourage cooperation in this project, and copies of the MISPL algorithm and tolerance tables can be obtained free of charge from the corresponding author.