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Thin-layer chromatographic screening program for commonly used beta-blockers.

This article reports thin-layer chromatographic data (corrected Rf-values; Rcf-values) of 20 commonly used beta-blockers which are regularly encountered in toxicological analysis. Silica gel was used as stationary phase and ten systems according to the proposals of the German Research Foundation (Deutsche Forschungsgemeinschaft; DFG) were chosen as solvents.

Adrenergic beta-Antagonists↗

Maternal serum alpha-fetoprotein screening programs and quality control for laboratories performing maternal serum and amniotic fluid alpha-fetoprotein assays: policy statement. American Society of Human Genetics.

Maternal serum alpha-fetoprotein (MSAFP) values are used primarily but not solely to predict the occurrence of open neural tube defects in the fetus; their use for prediction of Down's syndrome is a new initiative under investigation. The test is a good one, as far as such a test can be, but it is imperfect, because false-negative and false-positive results both occur. In other words, it is not an infallible test. To use the test as effectively as is currently possible requires a program capable of supplying baseline values in sufficient number and the follow-up procedures necessary for interpretation of positive tests. In other words, it is not simply an office test. Because there is no effective treatment to relax the burden of neural tube defects in the large majority of patients, prevention of disease involves termination of pregnancy at present. In other words, use of the test is value laden and controversial for some sectors of society. Despite its imperfections, the need for an elaborate societal structure to apply it, and its value-laden context the test is considered by many as a necessary procedure to maintain normal standards of practice. Indeed, the American College of Obstetricians and Gynecologists issued a statement advising its fellows to be aware of the availability of MSAFP testing and to discuss such testing with patients. It is natural that confusion about protocol and anxiety about practice and its consequences are prevalent in this context. The American Society of Human Genetics (ASHG) offers here a statement about issues that affect MSAFP testing and the attendant pitfalls.

Amniotic Fluid↗

How much quality control is enough? A cost-effectiveness model for clinical laboratory quality control procedures (illustrated by its application to a ligand-assay-based screening program).

Quality assurance testing represents a substantial proportion of the clinical laboratory budget, but current guidelines are based on criteria that pertain to analytic error rather than to optimization of the cost-effectiveness of patient care. A general Bayesian mathematical model for the cost-effectiveness of assay quality control has been developed, and is demonstrated using previously published data. The cost-effectiveness of quality assurance as defined here depends upon the prevalence of disease, the shapes of the distributions of test results observed in the non-diseased and diseased populations, the decision limit selected for labeling results positive or negative, the costs and benefits associated with each of the possible therapeutic outcomes, the magnitude of random and systematic analytical errors, the statistical power of the quality control test in use, the costs associated with delays due to re-assay, and the proportion of total test cost attributable to quality control procedures. Given current clinical laboratory practice, much of this information will not be routinely available. The model combines these factors into a simple equation with three terms: one for the cost of the original and any required repeat laboratory analyses, one for the cost of delay entailed by the rejection of an assay batch, and one for the change in total costs consequent to rejection of erroneous assay results.

Clinical Laboratory Techniques↗