Labguy

Unless you are doing a TON of CSF testing it wont make sense. The analyzer reagents are incredibly expensive. We calculated that the cost per test would be between 150 and 300 per sample depending on volume!

We have used this assay for years without issue or complaint. If you ant any specific info let me know.

I would agree that you should consider Sysmex. I have used most of the vendors over the years and was a Beckman guy up until a couple years ago when I first tried Sysmex. Not going back. Steer clear of both Abbott and Advia. They are both troublesome.

We use a fax server which autofaxes results to the ordering physician. Requests for faxed results after the fact are forwarded to HIM. Either way the tech has no involvement.

My opinion is that for the analyzer your using it is definitely over calibration. First, CAP and CLIA definately DO NOT require this. Second, it is incredibly wasteful to perform all those multipoint calibrations and QC to turn out a patient result. I find it hard to believe your profiting on this testing unless your volume is very high. Third, it seems to me that calibrating that often could potentially hide imprecision in your analyzer. In other words, if there were something wrong with the analyzer that would cause the results to drift, you would not catch it since you’re constantly ajusting your curve. Fourth, and perhaps most importantly, calibration is not without its dangers. What if there was a random inaccuracy in one of the calibration tests; enough to cause a shift, but not a failure. It seems to me that you could actually make a good assay less accurate by calibrating it.

On what kind of analyzer are you performing these tests?

Excerpt from - Arch Pathol Lab Med—Vol 137, August 2013 - available online Currently there is no guideline on whether confirmatory testing needs to be done for urine ketones or bilirubin. The Clinical and Laboratory Standards Institute has stated that ‘‘many of the historical confirmatory chemical urinalysis tests such as the sulfosalicylic acid (SSA) test for protein, the tablet test for ketones, and the tablet test for bilirubin may not be relevant to current laboratory practice.’’ 2 The College of American Pathologists does not require these confirmations and suggests that users follow the manufacturer’s recommendations. In summary, using the same or a similar qualitative methodology to confirm another qualitative method duplicates work, increases costs, and may provide misleading information. Thus, such confirmatory tests should be discontinued. Confirmatory and complementary tests such as serum bilirubin and ketones (in particular bhydroxybutyrate) should be ordered when clinically warranted. Our laboratory has discontinued all confirmatory testing.