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At least 397 records · Page 22Linked to original sources

Prototype application of a robot in the clinical laboratory enabling fully automated quantification of fecal porphyrins.

Unpleasant specimens, sensitive analytes, and a lengthy chromatographic procedure were the main reasons we implemented fecal porphyrin analysis with a laboratory robot. We describe the system in detail and compare it with the same technique performed manually. The day-to-day variation of assays of standards was lower with the robot than with the manual operation: 8% (CV) for coproporphyrin I and 11% for protoporphyrin IX. We repeatedly analyzed a specimen from a healthy volunteer and determined that the specimen contained (in nmol/g dry wt) 7.1 (SD 0.7) for coproporphyrin I, 3.0 (SD 0.4) for coproporphyrin III, and 44.4 (SD 4.3) for protoporphyrin IX. Upper reference limits as measured in 20 healthy volunteers were 20 nmol/g dry wt for coproporphyrin I, 12 nmol/g for coproporphyrin III, and 80 nmol/g for protoporphyrin IX. We also present characteristic chromatograms for samples from various different porphyrias that exhibit abnormal fecal porphyrin excretion. Calculations of return on investment show that the robot, working at full capacity, is a profitable tool.

Autoanalysis↗

Improving response to critical laboratory results with automation: results of a randomized controlled trial.

OBJECTIVE: To evaluate the effect of an automatic alerting system on the time until treatment is ordered for patients with critical laboratory results. DESIGN: Prospective randomized controlled trial. INTERVENTION: A computer system to detect critical conditions and automatically notify the responsible physician via the hospital's paging system. PATIENTS: Medical and surgical inpatients at a large academic medical center. One two-month study period for each service. MAIN OUTCOMES: Interval from when a critical result was available for review until an appropriate treatment was ordered. Secondary outcomes were the time until the critical condition resolved and the frequency of adverse events. METHODS: The alerting system looked for 12 conditions involving laboratory results and medications. For intervention patients, the covering physician was automatically notified about the presence of the results. For control patients, no automatic notification was made. Chart review was performed to determine the outcomes. RESULTS: After exclusions, 192 alerting situations (94 interventions, 98 controls) were analyzed. The intervention group had a 38 percent shorter median time interval (1.0 hours vs. 1.6 hours, P = 0.003; mean, 4.1 vs. 4.6 hours, P = 0.003) until an appropriate treatment was ordered. The time until the alerting condition resolved was less in the intervention group (median, 8.4 hours vs. 8.9 hours, P = 0.11; mean, 14.4 hours vs. 20.2 hours, P = 0.11), although these results did not achieve statistical significance. The impact of the intervention was more pronounced for alerts that did not meet the laboratory's critical reporting criteria. There was no significant difference between the two groups in the number of adverse events. CONCLUSION: An automatic alerting system reduced the time until an appropriate treatment was ordered for patients who had critical laboratory results. Information technologies that facilitate the transmission of important patient data can potentially improve the quality of care.

Academic Medical Centers↗

[Laboratory evaluation of automated enzyme linked fluorescent assay for detecting serum specific IgG antibodies against rubella virus].

The VIDAS rubella IgG(RBG) is a new, automated, enzyme-linkad fluorescent assay(ELFA) for detecting IgG antibodies to rubella virus in serum. The purpose of this study was to evaluate the usefulness of the qualitative and quantitative VIDAS RBG as laboratory tests in the rapid detecting anti-rubella IgG antibodies. Simultaneous parallel testing was performed by using the qualitative and quantitative RBG along with RUBAZYME(ABBOTT LABORATORIES) and the standard hemagglutination-inhibition(HI) test(R-HI kit, SEIKEN) on 200 blood samples submitted for anti-rubella IgG antibodies testing from patients at the VGH-Kaohsiung(Mar.-Sep., 1993). The qualitative and quantitative VIDAS RBG and RUBAZYME assay were compared to the standard R-HI test. Significant differences among the sensitivities of these three methods were found (100% sensitivity for the qualitative VIDAS RBG, 88.89% for the quantitative VIDAS RBG and 97.67% for the RUBAZYME). However, the specificities of these three methods were all the same, 100%. With these results we can conclude that the qualitative VIDAS RBG will provide a very good, precise and reliable method to determine serum specific IgG antibodies against rubella virus. Furthermore, the VIDAS RBG is fully automated and time-saving procedures (for every batch of test, it takes 25 minutes with VIDAS RBG, 2.5 hours with RUBAZYME and 4.5 hours with R-HI) in clinical laboratories.

Antibodies, Viral↗

Automated normal-phase preparative high-performance liquid chromatography as a substitute for flash chromatography in the synthetic research laboratory.

An automated normal-phase preparative HPLC system was developed in order to omit time-consuming flash column chromatography in the synthetic research laboratory. The system is equipped with steel columns packed with spherical 12 microm silica and is able to separate samples in a range of 0.1-10 g depending on the column diameter and chromatographic problem. It was designed to be used as an open access instrument in the research department. The general users select from binary gradient programs after running an analytical TLC with the raw product. The HPLC instrument was fully controlled by the Chromeleon software from Dionex. A Gilson 215 robot served as injector/collector.

Automation↗

Automating the sleep laboratory: implementation and validation of digital recording and analysis.

OBJECTIVES: We report on the implementation of digital processing in a large clinical and research sleep laboratory. The system includes the digital collection, display, analysis, and repository of physiological signals collected during sleep. METHODS: After describing the original analog system, the computer equipment and software necessary for the digital implementation are presented and we explain our algorithms for rapid eye movement (REM) and delta-wave detection. Finally, we describe an experiment validating the digital system of display and analyses. CONCLUSIONS: The digital processing of sleep signals saves computer operator, polysomnographic technologist, and computer time. It also saves resources such as polysomnographic paper and FM tape. The digital signals lend themselves to a large array of analysis techniques and result in improved signal quality. Automated REM and delta-wave detection via digital processing correlate highly with visual counts of rapid eye movements and delta waves.

Algorithms↗

Automation of a Flow Cytometry Clinical and Research Laboratory.

We developed a system to automate a Flow Cytometry Clinical and Research Laboratory. Five major functions are accomplished: 1) patient demographic data entry, 2) specimen results data transfer, 3) procedure transcription and reporting, 4) data query, and 5) data backup and archiving. These are achieved by inter-linking two computers with dissimilar operating systems with a Fluorescence Activated Cell Analyzer (FACScan), several commercially available software systems, an IEEE-488 GPIB parallel cable interface using IEEE protocol and Hewlett Packard User Group software (HPPCLINK), and a customized in-house developed laboratory automation system for integrated database management. The system consists of data entry and editing, procedure results reporting, data query, and data archiving modules. The system design ensures data integrity, quality, and confidentiality.

Computer Systems↗