Sant Feliu de Llobregat, Spain
Sant Feliu de Llobregat, Spain

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Llopis M.A.,Laboratori Clinic Hospital Universitari Germans Trias i Pujol Metropolitana Nord | Bauca J.M.,Commission on Quality Assurance in the Extraanalytical Phase | Bauca J.M.,Hospital Universitari Son Espases | Barba N.,Commission on Quality Assurance in the Extraanalytical Phase | And 17 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2017

Preanalytical variables, such as sample collection, handling and transport, may affect patient results. Preanalytical phase quality monitoring should be established in order to minimize laboratory errors and improve patient safety. A retrospective study (2001-2013) of the results obtained through the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) External quality assessment (preanalytical phase) was performed to summarize data regarding the main factors affecting preanalytical phase quality. Our aim was to compare data from 2006 to 2013 with a previously published manuscript assessing the 2001-2005 period. A significant decrease in rejection rates was observed both for blood and urine samples. For serum samples, the most frequent rejection causes in the first period were non-received samples (37.5%), hemolysis (29.3%) and clotted samples (14.4%). Conversely, in the second period, hemolysis was the main rejection cause (36.2%), followed by non-received samples (34.5%) and clotted samples (11.1%). For urine samples, the main rejection cause overall was a non-received sample (up to 86.1% of cases in the second period, and 81.6% in the first). For blood samples with anticoagulant, the number of rejections also decreased. While plasma-citrate-ESR still showed the highest percentages of rejections (0.980% vs. 1.473%, p<0.001), the lowest corresponded to whole-blood EDTA (0.296% vs. 0.381%, p<0.001). For the majority of sample types, a decrease in preanalytical errors was confirmed. Improvements in organization, implementation of standardized procedures in the preanalytical phase, and participation in a Spanish external quality assessment scheme may have notably contributed to error reduction in this phase. © 2017 Walter de Gruyter GmbH, Berlin/Boston.


Formiga F.,Hospital Universitari Of Bellvitge | Padros G.,Laboratori Clinic LHospitalet | Sarro M.,Lhospitalet Of Llobregat | Almeda J.,Lhospitalet Of Llobregat
Revista Espanola de Geriatria y Gerontologia | Year: 2010

Introduction: People aged 85 years old and older constitute a growing population group. Falls and malnutrition are common in the elderly. Objective: To determine the effectiveness of an individualized multifactorial intervention to reduce falls and malnutrition in community-dwelling persons aged 85 years old. Material and methods: The OCTABAIX study is a randomized controlled clinical trial lasting 3 years in primary care in Costa de Ponent (seven primary care teams). Community-dwelling elders born in 1924 who agreed to participate in the study have been included. Three in-home visits will be made annually by a trained nurse or physician and will be complemented by two biannual analytical studies. Participants will be followed-up for hospitalizations, falls and weight using a monthly calendar. The specifically-designed algorithm to detect risk factors for falls and malnutrition will be used to provide recommendations and specific, standardized interventions for risk reduction in a randomly selected intervention group. Two face-to-face interventions will be carried out and telephone calls will be made to reinforce adherence. The control group will follow routine primary care recommendations. The primary outcome is a decline in the rate of falls and malnutrition. Results: The OCTABAIX study aims to reduce the incidence of falls and the risk of malnutrition in the 328 patients included. Conclusions: The OCTABAIX study will help to determine the characteristics of persons aged 85 years old as well as the rate of falls and nutritional risk. The effectiveness of the measures adopted to reduce these geriatric syndromes will also be assessed. © 2009 SEGG.


Perich C.,SEQC Analytical Quality Commission | Perich C.,Laboratori Clinic Bon Pastor | Ricos C.,SEQC Analytical Quality Commission | Alvarez V.,SEQC Analytical Quality Commission | And 20 more authors.
Clinica Chimica Acta | Year: 2014

Introduction: Current external quality assurance schemes have been classified into six categories, according to their ability to verify the degree of standardization of the participating measurement procedures. SKML (Netherlands) is a Category 1 EQA scheme (commutable EQA materials with values assigned by reference methods), whereas SEQC (Spain) is a Category 5 scheme (replicate analyses of non-commutable materials with no values assigned by reference methods). Aim: The results obtained by a group of Spanish laboratories participating in a pilot study organized by SKML are examined, with the aim of pointing out the improvements over our current scheme that a Category 1 program could provide. Method: Imprecision and bias are calculated for each analyte and laboratory, and compared with quality specifications derived from biological variation. Results: Of the 26 analytes studied, 9 had results comparable with those from reference methods, and 10 analytes did not have comparable results. The remaining 7 analytes measured did not have available reference method values, and in these cases, comparison with the peer group showed comparable results. The reasons for disagreement in the second group can be summarized as: use of non-standard methods (IFCC without exogenous pyridoxal phosphate for AST and ALT, Jaffé kinetic at low-normal creatinine concentrations and with eGFR); non-commutability of the reference material used to assign values to the routine calibrator (calcium, magnesium and sodium); use of reference materials without established commutability instead of reference methods for AST and GGT, and lack of a systematic effort by manufacturers to harmonize results. Conclusions: Results obtained in this work demonstrate the important role of external quality assurance programs using commutable materials with values assigned by reference methods to correctly monitor the standardization of laboratory tests with consequent minimization of risk to patients. © 2013 Elsevier B.V.


Fernandez P.,Institute Catala Of La Salut Ics | Llopis M.A.,Laboratori Clinic Barcelones Nord i Valles Oriental | Perich C.,Laboratori Clinic Bon Pastor | Alsina M.J.,Laboratori Clinic Barcelones Nord i Valles Oriental | And 13 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2014

Background: Hemolysis is the main cause of non-quality samples in clinical laboratories, producing the highest percentage of rejections in the external assurance programs of preanalytical quality. The objective was to: 1) study the agreement between the detection methods and quantification of hemolysis; 2) establish comparable hemolysis interference limits for a series of tests and analytical methods; and 3) study the preanalytical variables which most influence hemolysis production.Methods: Different hemoglobin concentration standards were prepared using the reference method. Agreement was studied between automated methods [hemolytic indexes (HI)] and reference method, as well as the interference according to hemolysis degree in various biochemical tests was measured. Preanalytical variables which could influence hemolysis production were studied: type of extraction, type of tubes, transport time, temperature and centrifugation conditions.Results: Good agreement was obtained between hemoglobin concentrations measured using the reference method and HI, for the most of studied analyzers, particularly those giving quantitative HI. The hemolysis interference cut-off points obtained for the majority of tests studied (except LDH, K) are dependent on the method/analyzer utilized. Furthermore, discrepancies have been observed between interference limits recommended by the manufacturer. The preanalytical variables which produce a lower percentage of hemolysis rejections were: centrifugation at the extraction site, the use of lower volume tubes and a transport time under 15 min at room temperature.Conclusions: The setting of interference limits (cut-off) for each used test/method, and the study of preanalytical variability will assist to the results harmonization for this quality indicator.


PubMed | Hospital Universitario La Paz, Laboratoris Clinics Hospital Vall dHebron, SEQC Analytical Quality Commission, Hospital Royo Villanova and 5 more.
Type: | Journal: Clinica chimica acta; international journal of clinical chemistry | Year: 2014

Current external quality assurance schemes have been classified into six categories, according to their ability to verify the degree of standardization of the participating measurement procedures. SKML (Netherlands) is a Category 1 EQA scheme (commutable EQA materials with values assigned by reference methods), whereas SEQC (Spain) is a Category 5 scheme (replicate analyses of non-commutable materials with no values assigned by reference methods).The results obtained by a group of Spanish laboratories participating in a pilot study organized by SKML are examined, with the aim of pointing out the improvements over our current scheme that a Category 1 program could provide.Imprecision and bias are calculated for each analyte and laboratory, and compared with quality specifications derived from biological variation.Of the 26 analytes studied, 9 had results comparable with those from reference methods, and 10 analytes did not have comparable results. The remaining 7 analytes measured did not have available reference method values, and in these cases, comparison with the peer group showed comparable results. The reasons for disagreement in the second group can be summarized as: use of non-standard methods (IFCC without exogenous pyridoxal phosphate for AST and ALT, Jaff kinetic at low-normal creatinine concentrations and with eGFR); non-commutability of the reference material used to assign values to the routine calibrator (calcium, magnesium and sodium); use of reference materials without established commutability instead of reference methods for AST and GGT, and lack of a systematic effort by manufacturers to harmonize results.Results obtained in this work demonstrate the important role of external quality assurance programs using commutable materials with values assigned by reference methods to correctly monitor the standardization of laboratory tests with consequent minimization of risk to patients.


Gella F.J.,Biosystems S. A. | Alsina M.J.,Laboratori Clinic Barcelones Nord i Valles Oriental | Biosca C.,Hospital Universitari Germans Trias i Pujol | Serrat N.,Hospital Universitari Joan | And 9 more authors.
Revista del Laboratorio Clinico | Year: 2015

Introduction: Hemolysis, turbidity and the presence of high concentrations of bilirubin are the most frequent sources of interference in the clinical laboratory. Many analyzers incorporate detection systems for these interferents called "serum indexes" of hemolysis, icterus and lipidemia. The accuracy of such indexes is usually not verified by the difficulty in obtaining appropriate reference materials. In this work we show the results of an interlaboratory study of hemolysis, icterus and lipidemia indexes using reference materials containing known concentrations of these interfering substances. Material and methods: Ten clinical laboratories from different centres have participated in the study using 7 different analyzers. The reference materials for the serum indexes contained known concentrations of bilirubin, hemoglobin (hemolysate) and triglycerides (Intralipid). Results: All instruments provided acceptable results for the icterus and hemolysis index. Among the analyzers providing quantitative values, low results were found in one of the analyzers for materials containing Intralipid. The analyzers expressing the result as an interval provided correct results for materials with low turbidity but a low result for the material with the highest turbidity. Conclusions: The reference materials used have proved to be useful to verify the serum indexes for hemolysis, icterus and lipidemia in analyzers. The results obtained in different instruments generally agree among them and with the assigned values. The most important differences between analyzers were found in the lipidemia index. © 2014 AEBM, AEFA y SEQC.


Ricos C.,Analytical Quality Commission | Alvarez V.,Analytical Quality Commission | Alvarez V.,Laboratori Clinic lHospitalet | Perich C.,Analytical Quality Commission | And 21 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2015

The aims of this study are: 1) to use the data included in the biological variation (BV) database to address the usability of BV estimates; and 2) to use different examples from the authors' laboratories to illustrate the use and the usefulness of BV data in laboratory medicine. The BV database is an essential tool for laboratory management. Examples of application of data derived from BV are given in this paper, such as analytical performance specifications that have been included in various quality control software designed to optimize operative rules; also they have been incorporated as acceptability limits in external quality assurance reports. BV data from pathological status are of utmost interest for monitoring patients and differences between the intra-individual coefficients of variation (CVI) estimated from healthy and patients are shown. However, for a number of analytes there are limited data available and for many there are no data, consequently new studies should be encouraged at an international level. In addition, developing international criteria to evaluate publications dealing with the estimation of BV components would be of the utmost interest. We are ready and willing to collaborate with such worthy initiatives. The first EFLM strategic conference on analytical performance specifications is an excellent opportunity for debating these ideas. © 2015 by De Gruyter.


Ruiz R.,Laboratori Clinic lHospitalet | Llopis M.A.,Laboratori Clinic Barcelones Nord i Valles Oriental | Biosca C.,Servei Of Bioquimica Clinica Hospital Germans Trias I Pujol | Trujillo G.,Laboratori Clinic Bages | And 14 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2010

Background: Quality specifications for indicators of the key analytic processes have been defined by international consensus. However, only preliminary specifications for laboratory-related strategic and support processes have been developed. The present study attempts to increase the robustness of the preliminary proposed specifications. Methods: Recovering records and incidences occurred over a 4-year follow-up period, for 12 indicators, used in all laboratories from this group regarding strategic and support processes. Results and conclusions: The results obtained indicate that it is better to establish an interval rather than a fixed value for the majority of indicators. Longer studies are needed to properly assess some quality specifications, and data recording system must be standardized in others. Additional, multicenter studies are needed to establish more robust specifications and determine the state of the art of laboratories in other settings. © 2010 by Walter de Gruyter, Berlin, New York.


Ferrer A.,Institute Catala Of La Salut | Formiga F.,Hospital Universitari Of Bellvitge | Padros G.,Laboratori Clinic lHospitalet | Badia T.,Institute Catala Of La Salut | And 2 more authors.
Revista Espanola de Geriatria y Gerontologia | Year: 2016

This is a review of a prospective, community-based study with a follow-up period of 5. years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5. years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group. © 2016 SEGG.


PubMed | Institute Catala Of La Salut, Laboratori Clinic lHospitalet, Hospital Universitari Of Bellvitge and Institute Universitari dInvestigacio en Atencio Primaria Jordi Gol Jordi Gol
Type: Journal Article | Journal: Revista espanola de geriatria y gerontologia | Year: 2016

This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijn test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group.

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