Acute Kidney Injury and Antimicrobial Stewardship
Acute Kidney Injury and Antimicrobial Stewardship
An estimated 1 in 5 hospital admissions in the UK is associated with acute kidney injury1, providing a clear illustration of the need for novel, rapid detection methods. Our latest whitepaper looks at this common condition and the links between Acute Kidney Injury and Antimicrobial Stewardship. For more details on the things discussed in this article, you can download the full whitepaper below.
Acute Kidney Injury
Acute Kidney Injury is defined as a sudden loss of kidney function. This causes a disruption in the kidneys’ ability to filter waste out of your blood resulting in an accumulation of waste products as well as other imbalances.
The loss of kidney function is the result of a sudden reduction in glomerular filtration rate (GFR), the process through which waste is extracted from the blood and is often reversible2.
Aetiology of Acute Kidney Injury
The differential pressure existing between the glomerulus and Bowman’s is the driving mechanism for glomerular filtration2. This pressure contrast is influenced by the combined resistances of the afferent (leading to the glomerulus) and efferent (leading away from the glomerulus) vascular pathways in the kidney. Under normal kidney function, these resistances are in equilibrium, facilitating the proper functioning of the GFR. For example, an increase in efferent resistance restricts the blood flow out of the kidney, elevating pressure inside the kidney and reducing GFR, and vice versa2. However, in AKI, the decline in renal blood flow and GFR has a pathological origin. The pathophysiology of AKI can be classified as prerenal, intrinsic renal, or postrenal.
Pre-renal Acute Kidney Injury
Pre-renal AKI is caused by reduced afferent blood flow or, in other words, increased afferent resistance. While tubular and glomerular functions generally remain intact, pre-renal AKI may be caused by systemic hypoperfusion (decreased blood flow) or selective hypoperfusion to the kidney, caused by renal artery stenosis or aortic dissection3.
Intrinsic Renal Acute Kidney Injury
Renal AKI describes the conditions which affect the glomerulus or tubule, for example, acute tubular necrosis and acute interstitial nephritis. This collection of conditions is associated with vasoconstrictor expression in renal afferent pathways2.
Post-renal Acute Kidney Injury
Post-renal AKI usually results from an obstruction in the filtration system. Causes of obstruction include kidney stones, tumours, or blood clots, commonly in the bladder outlet. Obstruction affecting one side might not invariably lead to acute kidney injury, especially when the impediment develops slowly, such as with tumour growth. This is because the unaffected kidney might be able to adjust and make up for the compromised functionality3
Symptoms & Treatment
AKI often manifests with decreased urine output as its primary symptom. However, additional symptoms, when present, can encompass fatigue, nausea, vomiting, or confusion4. To achieve an accurate diagnosis, a comprehensive review of the patient’s medical history and a physical examination are essential to identify the underlying cause of the condition.
The treatment and management of AKI are contingent upon the root cause of the condition. In milder cases, measures are implemented to maintain appropriate levels of fluid, electrolytes, and blood pressure. Nutritional support may also be administered when necessary. In the most severe instances of AKI, dialysis may be warranted to compensate for the diminished kidney function5.
Creatinine serves as a valuable diagnostic tool for evaluating renal conditions, including kidney health, GFR, and muscular dystrophy. However, abnormal serum creatinine (SCr) levels only become evident when a significant portion of the renal mass is compromised. The kidneys possess an impressive capacity to adapt to reduced function, which means that a considerable loss of function or GFR is necessary to influence SCr levels. This poses a challenge when it comes to early detection of AKI6.
Novel biomarkers, KIM-1, NGAL, Clusterin, and Cystatin C, are associated with AKI2 and can be analysed through molecular testing. These new methods can provide a fast and accurate assessment of an individual’s kidney health, at a much earlier stage than SCr quantification2.
Antimicrobial Stewardship
Antimicrobial Stewardship (AMS) programs are specifically crafted to enhance the efficiency of antimicrobial utilization, curtail the emergence of Antimicrobiasl Resistance (AMR), and enhance patient outcomes7. These programs encompass a variety of approaches, such as educational initiatives, training, the establishment of guidelines and protocols, ongoing monitoring and feedback regarding antimicrobial usage, and the management of antimicrobial formularies. Through the promotion of prudent antibiotic utilization, AMS programs contribute to the safeguarding of the efficacy of currently available antimicrobial agents and the deceleration of AMR development7.
Antibiotics and Acute Kidney Injury
Various antibiotics are associated with the progression of AKI due to their nephrotoxicity which can cause severe damage to the kidneys. These antibiotics include polymyxins, aminoglycosides and the commonly used, vancomycin8.
Randox Renal Injury Detection
Using the patented Biochip Technology, the Randox Acute Kidney Injury (AKI) array, available on the Evidence Investigator, simultaneously tests for four novel biomarkers (KIM-1, NGAL, Clusterin, Cystatin C) delivering an early diagnosis and monitoring of treatment efficacy. Multiplex testing better captures reduced renal function, as each biomarker reflects different mechanisms that result in similar injury outputs, allowing for a more accurate picture of the underlying cause of AKI. Along with being able to identify AKI at a much earlier stage, this array provides an accurate and sensitive solution for the diagnosis and monitoring of AKI.
If you’d like some more information on the Randox Acute Kidney Injury Array or would like to add this technology to your laboratory, take a look at our website at https://www.randox.com/acute-kidney-injury/ or get in touch today at marketing@randox.com.
References
- NICE. How common is it? Acute Kidney Injury . Published July 2023. Accessed October 2, 2023. https://cks.nice.org.uk/topics/acute-kidney-injury/background-information/prevalence/
- Adiyanti SS, Loho T. Acute Kidney Injury (AKI) Biomarker.; 2012.
- Manzoor H, Bhatt H. Prerenal Kidney Failure.; 2023.
- NHS. Acute Kidney Injury. NHS. Published 2023. Accessed July 31, 2023. https://www.nhs.uk/conditions/acute-kidney-injury/
- Goyal A, Daneshpajouhnejad P, Hashmi M, Bashir K. Acute Kidney Injury . In: StatPearls [Internet]. StatPearls Publishing ; 2023.
- Rule AD, Lieske JC. The estimated glomerular filtration rate as a test for chronic kidney disease: Problems and solutions. Cleve Clin J Med. 2011;78(3):186-188. doi:10.3949/ccjm.78a.11004
- Baur D, Gladstone BP, Burkert F, et al. Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis. Lancet Infect Dis. 2017;17(9):990-1001. doi:10.1016/S1473-3099(17)30325-0
- Clifford KM, Selby AR, Reveles KR, et al. The Risk and Clinical Implications of Antibiotic-Associated Acute Kidney Injury: A Review of the Clinical Data for Agents with Signals from the Food and Drug Administration’s Adverse Event Reporting System (FAERS) Database. Antibiotics. 2022;11(10):1367. doi:10.3390/antibiotics11101367
National Cholesterol Month
National Cholesterol Month
Foe or Friend? Your Health is your Wealth.
It’s National Cholesterol Month, time to raise awareness on the dangers high cholesterol can have on your body and the strain it can have on your precious heart, the centre piece and vital organ that keeps you alive and pumps blood to every corner of your body.
Cardiovascular disease is the leading killer, claiming 17.9 million lives globally each year. 80% of these are due to strokes and heart attacks. Its not too late to get checked out and to alter your lifestyle habits.
Randox Laboratories provides a comprehensive range of reagents for Cardiovascular disease with sdLDL providing detailed testing of cholesterol levels and overall Cardiovascular Health, see more in the blog below.
Cholesterol can be a friend, but it can also be a foe. Maybe you associate bad cholesterol with the result of being overweight, this is not always the case, without a balanced diet, essential exercise, you are at risk of being in the cholesterol danger zone.
Small dense Low-Density Lipoprotein (sdLDL) carries cholesterol to and from cells in the body, it is one of two proteins. However, it is more atherogenic than LDL cholesterol meaning it has a higher tendency to leave fatty deposits in the blood and has a greater ability to block arteries.
Low-density lipoprotein (LDL) is key for progression and development of cardiovascular disease and plague build up (atherosclerosis). LDL has a couple of subclasses sdLDL being one, making it a more reliable marker for the discovery and testing of cardiovascular issues.
sdLDL has a significantly greater atherogenic potential than LDL sub-group. This makes the portion of sdLDL a better marker to predict cardiovascular disease and issues than LDL. It provides a greater understanding of lipoprotein risk within patients; it is more comprehensive in detecting cardiovascular risk in comparison to the original LDL-C test. It is a valuable screening tool in allowing to detect for diseases and abnormalities in the cardiovascular system. As sdLDL-C is particularly atherogenic, a person with elevated sdLDL-C levels has a 3-fold increased risk of myocardial infarction.
Randox provides the “only direct automated sdLDL-C kit on the market, The Randox sdLDL-C ‘Ex-Seiken’ test is a direct method for the quantitative determination of sdLDL-C using automated chemistry analysers, capable of accommodating two-reagent assays. The assay consists of two steps and is based on the use of well-characterised surfactants and enzymes that selectively react with certain groups of lipoproteins.”
Benefits include,
- Direct, automated test for convenience and efficiency
- Rapid analysis results can be produced in as little as ten minutes, facilitating faster patient diagnosis and treatment plan implementation.
- Good correlation to the gold standard ultracentrifugation method
- Liquid ready-to-use reagents for convenience and ease of use
- Applications available detailing instrument specific settings for a wide range of analysers
- Clearance method sdLDL-C controls and calibrator available.
Foe or Friend? Your Health is your Wealth.
References
Fernandez-Alvarez R, Gonzalez-Rodriguez AP, Gonzalez E, Rubio-Castro A, Dominguez-Iglesias F, et al. Serum Ferritin as Prognostic Marker in Classical Hodgkin Lymphoma Treated With ABVD-based Therapy. Leukemia & Lymphoma . 2015;56(11):3096-3102.
Randox (2023) Ferritin: Reagents, Randox Laboratories. Available at: https://www.randox.com/ferritin/ (Accessed: 20 September 2023).
Rosário C, Zandman-Goddard G, Meyron-Holtz EG, D’Cruz DP, Shoenfeld Y. The hyperferritinemic syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome. BMC Medicine . 2013;11(185).
Sharma J, Sharma R. A prognostic marker in patients with sepsis in pediatric age group: A prospective cohort study. International Journal of Medical and Health Research . 2018;4(3):86-89.
The Royal College of Pathologists. Guidance on the Use and Interpretation of Clinical Biochemistry Tests in Patients with COVID-19 Infection.; 2020. Accessed September 18, 2023. https://www.rcpath.org/uploads/assets/3f1048e5-22ea-4bda-953af20671771524/G217-RCPath-guidance-on-use-and-interpretation-of-clinical-biochemistry-tests-in-patients-with-COVID-19-infection.pdf
World Health Organisation. WHO Guideline on Use of Ferritin Concentrations to Assess Iron Status in Individuals and Populations.; 2020. Accessed September 18, 2023. https://www.who.int/publications/i/item/9789240000124
World Heart Day
World Heart Day!
The powerhouse of the body, beating 100,00 times every day, pumping eight pints of blood, through an intertwining network of blood vessels. Delivering oxygen and nutrients to muscles and the vital organs of the body. The centrepiece, what keeps us alive, the heart!
Why put strain on the very thing that keeps us alive? The heart is the most important muscle working constantly, embracing a healthy lifestyle can lower the risk of developing a stroke or heart attack, and can prevent cardiovascular disease. No matter your age young or old, you can begin to take care of your heart. Making healthier choices, watching what you eat, exercising regularly are all good habits to start or continue to look after your precious heart.
Randox Laboratories offer a wide selection of Reagents specifically for Lipid testing. Lipid tests are the most important cardiac risk tests. They assess an individual’s risk of a stroke or heart attack and can provide an indication if someone is going to have a cardiac episode, caused by blockages of arteries and blood vessels. Lipid tests screen for abnormalities of cholesterol and triglyceride levels in the blood, allowing for preventative measures to take place to reduce the chances of cardiovascular diseases.
Complete lipid profiles consist of HDL Cholesterol, LDL Cholesterol, Total Cholesterol and Triglycerides. These profiles measure the current cholesterol and triglycerides levels also, measuring potential emerging risk factors of cardiovascular disease.
‘Benefits of Randox’s Lipid testing includes;
Enhanced convenience with liquid ready-to-use reagents (Triglycerides kits also come in lyophilised form)
Excellent correlation to reference methods for security of accurate results
Applications for a wide range of clinical chemistry analysers
Wide measuring ranges able to comfortably detect abnormal lipid levels.
Cost effectiveness for even small throughput labs – all lipid assays are stable to expiry when stored at 2-8⁰C (except for Triglyceride kits, stable for 21 days)’
Randox provides the “only direct automated sdLDL-C kit on the market, The Randox sdLDL-C test, is a direct method for the quantitative determination of sdLDL-C using automated chemistry analysers, capable of accommodating two-reagent assays. The assay consists of two steps, and is based on the use of well-characterised surfactants and enzymes, that selectively react with certain groups of lipoproteins.
Benefits include,
Direct, automated test for convenience and efficiency
Rapid analysis results can be produced in as little as ten minutes, facilitating faster patient diagnosis and treatment plan implementation.
Good correlation to the gold standard ultracentrifugation method
Liquid ready-to-use reagents for convenience and ease of use
Applications available detailing instrument specific settings for a wide range of analysers
Clearance method sdLDL-C controls and calibrator available.
One of Randox’s Reagents offered is the Lipoprotein (a) assay known as Lp(a). It is similar to LDL cholesterol but a lot more viscous.
High levels of lipoprotein can clog arteries very easily, leading to the potential of a stroke or cardiovascular disease at any age. Lp(a) is made in the liver containing fat and protein, their main role is to carry lipids around the body. Lp(a) remains relatively stable over a lifespan and is determined predominantly through genetics. Just a single Lp(a) test is believed to be enough to improve accuracy of a cardiovascular risk assessment. Repeat testing can also be initiated if a secondary cause is suspected, or therapeutic measures to lower Lp(a) levels have been investigated.
Benefits of the Lp(a) assay;
WHO/IFCC Reference Material
Dedicated Five-Point Calibrator Available
Excellent Correlation
Excellent Precision
Liquid Ready-To-Use
Applications Available
References
BHF (2023) How your heart works, British Heart Foundation. Available at: https://www.bhf.org.uk/informationsupport/how-a-healthy-heart-works (Accessed: 19 September 2023).
Family Doctor (2023) Keeping Your Heart Healthy, familydoctor.org. Available at: https://familydoctor.org/keeping-heart-healthy/ (Accessed: 19 September 2023).
Heart UK (2023) High lipoprotein(a), What Is High lipoprotein(a)? | Cholesterol Conditions | HEART UK. Available at: https://www.heartuk.org.uk/genetic-conditions/high-lipoproteina (Accessed: 20 September 2023).
Randox (2023b) Lipid: Reagents, Randox Laboratories. Available at: https://www.randox.com/lipid-reagent (Accessed: 19 September 2023).
Charting the Course to Laboratory Excellence
Are you still using spreadsheets for your QC data and Charts?
You’ve been left behind.
But don’t worry!
Your laboratory’s ultimate ally in the quest for precision and excellence has arrived.
Acusera 24.7 is a tool that not only streamlines your QC data but also empowers you with a treasure trove of invaluable charts.
These charts are more than just numbers and lines; they are your secret weapon for troubleshooting, achieving accreditation, and driving continuous process improvement.
Acusera 24.7 doesn’t just offer charts. It offers a symphony of insights at your fingertips. From the precision of interactive Levey-Jennings charts to the competitive edge of performance summary charts for peer group comparison, from the rhythm of weekly mean charts to the clarity of reliable SD histograms – these charts are your compass in the world of quality control.
The best part?
You’re in control.
Tailor these charts to your unique needs, whether you’re dealing with single or multiple analytes, an abundance of QC lots, fixed or variable SDs, or need to pinpoint data within a specific date range.
Join us on a journey through the world of Acusera 24.7’s charts, where data becomes your strategic advantage, and discover why more laboratories are choosing Acusera 24.7 for QC data management every day.
Levey-Jennings Charts
Every laboratorian has seen countless Levey-Jennings charts and for good reason.
These charts are the unsung heroes of quality control in the laboratory.
They offer a visual snapshot of data over time, helping to detect trends, outliers, and systematic errors that might otherwise go unnoticed. Levey-Jennings charts are like the heartbeat monitor of your laboratory, providing real-time insights into the health of your analytical processes.
We’ve taken Levey-Jennings charts to the next level.
Our colourful graphs might look like they belong in a modern art museum, but trust me, they’re more than just eye candy.
Acusera 24.7’s Levey-Jennings charts are like the laboratory’s personal detective, sniffing out anomalies and shifts and making sure your QC data behaves.
Let’s have a look at what you can do with the Acusera 24.7 interactive Levey-Jennings charts.
The screenshot below shows a Levey-Jennings chart for a single analyte, with the date on the X-axis and SD on the Y-axis. On this chart, you can see data points displayed in different colours. Green data points indicate an acceptable result. Orange points show data that has triggered your predefined alert criteria, while red points are those that have broken your set rejection rules.
The lines marked on the chart below represent events that have been recorded. Instrument events such as calibration events or maintenance can be recorded to monitor their effects on your QC, allowing you to quickly see how these events relate to any deviations or improvements in your QC data. For example, after the event labelled ‘Reagent lot change’ you can see a series of alerts and failures. Marking this event on the chart allows for an at-a-glance explanation of this deviation. These events are completely customisable so you can record any relevant information you want!
Finally, data points that appear as a triangle indicate a comment has been added. What text is included in the comment is completely up to you!
The next screenshot below shows a Levey-Jennings chart containing QC data for all the tests included in the Clinical Chemistry Panel.
Acusera 24.7 panels allow you to group related tests together, helping increase the efficiency of your data review.
It looks great, right?
Maybe a little confusing.
The screenshot is perhaps a little deceptive.
When viewing these charts live, you can view the data as a whole, or home in on individual data sets by simply hovering over the data you want to see. You can also selected a deselect datasets at will by clicking on its name in the list below the chart.
The screenshot below shows an example of this.
All the charts we’ve looked at so far have had a fixed 3SD on the Y-axis.
For a more in-depth review of your data, you may wish to expand this axis.
With the click of a button, you can expand the Y-axis to include all your data points. See below for an example.
In some cases, you may wish to view this data displayed as ‘% Deviation’.
Again, with the click of a single button, you can convert the Y-axis to show just that, as shown below.
Performance Summary Charts
Peer group comparison of IQC data has a lot of benefits.
Comparing your data with other laboratories that use the same QC lot, instrument, method and more, can help you with troubleshooting and continuous process improvement.
The Acusera 24.7 Performance Summary Charts do all the work for you.
As shown in the screenshot below, these charts display your data and how it compares to your peers including mean, CV, and SD.
You can also view this data in a table to get a more detailed picture of your performance.
Like the Levey-Jennings charts, you can also combine this information for panels or a selection of multiple lots and analytes. You can see an example below:
Weekly Mean Charts
Weekly Mean Charts are one of the new features in our latest software release.
They allow you to view your weekly count of QC results for a specific instrument, assay, or lot.
Below is an example in a bar chart format.
You can also view this data as a line graph, which plots the weekly mean of results from multiple instruments using the same assay and QC lot, allowing a comprehensive overview of your QC data.
Or you can view your weekly means for a range of tests and panels.
Finally, the SD Histograms allow you to view the distribution of your results, for an overview of performance.
When used with Acusera 24.7’s suite of advanced statistical tools and reports, our charts can help you reduce the time you spend investigating non-conformances.
When the dreaded accreditation assessment approaches, you can relax. While others are scrambling to find documentation, you can rest assured that all the QC data you need is easily accessible.
Assessors love to see Acusera 24.7 load when they enter a laboratory because they understand how much easier QC management is when using our software.
We provide complete onboarding assistance and full training on the software for new customers while delivering prompt and effective customer support for existing users. The Acusera 24.7 and QC operations teams are always eager to help new and existing Acusera 24.7 users with any issues they experience.
To learn more about the features of this ground-breaking software, visit our website here.
Alternatively, feel free to reach out to us at marketing@randox.com for more information or to arrange a demo!
Ferritin-Blog
Ferritin Assay
Ferritin, a protein but also an indicator of the body’s iron levels and stores is valuable when tested alongside other proteins and lipids to identify the function of muscle metabolism, transporting oxygen and DNA synthesis.
Anaemia is the cause of iron deficiency, a shortage of red blood cells resulting in the stores being inadequate in meeting the necessary needs for metabolism. Literature has identified that this could be the result of haemolysis and excessive bleeding. Testing regarding Ferritin, renal function and glucose are used to determine the sole cause of anaemia. Some symptoms of this deficiency include extreme fatigue, decreased productivity, diminished physical performance and significantly reduced immunity. However, in stark contrast having an over accumulation of iron in the body can be the result of hereditary disorders of haemochromatosis and thalassaemia.
Iron seeks to bind with a protein as it’s very reactive as a biomarker, so while being stored in cells iron binds to Ferritin, this in turn makes Ferritin an ideal predictor of iron reserves. Toxicity from elemental iron causes tissue damage and collates free radicals. Excess iron collated in the body over time causes serious damage to the liver and vital organs, causing liver failure, cirrhosis, skin pigmentation, heart failure and arrythmia. There is no way to eliminate excess iron from the body, so regulation of iron stores is vital to check of changes in iron absorption. As Ferritin is the primary iron storage, without it iron levels cannot be regulated and can cause serious damage.
Ferritin itself is produced on a very small level before being released in the bloodstream. During inflammation episodes, due to infections, rare conditions or even obesity, Ferritin levels can become significantly elevated. It poses as a challenge to accurately diagnose iron deficiency and can unfortunately lead to a misled evaluation regarding the possible overload of iron. This issue is being worked on to resolve and be able to accurately measure iron levels while inflammation is present. CRP may also be used as an aid to help rule out the elevated Ferritin levels from the cause of inflammation.
Ferritin is described as ‘an intracellular hollow protein’, comprised of around 4500 iron atoms within the iron core, surrounding the core are 24 subunits. In contrast, a reduced Ferritin level in serum indicates a deficiency and or depletion of iron stores, however it may not determine advanced depletion.
Randox Laboratories offer an accurate Ferritin Assay, used to detect iron levels and aid in the diagnosis and treatment of conditions such as anaemia.
‘Benefits of the Ferritin Assay include’.
Wide measuring range of 5.08 – 443 mg/dl for the accurate detection of clinically important results
Automated immunoturbidimetric assay eliminating the need for any dedicated equipment.
Liquid ready-to-use reagents for convenience and ease-of-use
Stable to expiry when stored at +2 to +8°C.
Applications available detailing instrument-specific settings for the convenient use of the Randox Ferritin assay on a wide range of biochemistry analysers
Complementary controls and calibrators offering a complete testing package.
Some clinical points to note include. Ferritin has been observed in 89% of patients with Adult-Onset Stills Disease, there have been elevated Ferritin levels of five times the normal range in over half of patients with this disease. COVID-19 critically ill patients experienced elevated concentrations, along with Sepsis patients that are not recovering also experience a stark increase in their Ferritin levels.
Click the link below to find out more on our Ferritin Assay!
References
Fernandez-Alvarez R, Gonzalez-Rodriguez AP, Gonzalez E, Rubio-Castro A, Dominguez-Iglesias F, et al. Serum Ferritin as Prognostic Marker in Classical Hodgkin Lymphoma Treated With ABVD-based Therapy. Leukemia & Lymphoma . 2015;56(11):3096-3102.
Randox (2023) Ferritin: Reagents, Randox Laboratories. Available at: https://www.randox.com/ferritin/ (Accessed: 20 September 2023).
Rosário C, Zandman-Goddard G, Meyron-Holtz EG, D’Cruz DP, Shoenfeld Y. The hyperferritinemic syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome. BMC Medicine . 2013;11(185).
Sharma J, Sharma R. A prognostic marker in patients with sepsis in pediatric age group: A prospective cohort study. International Journal of Medical and Health Research . 2018;4(3):86-89.
The Royal College of Pathologists. Guidance on the Use and Interpretation of Clinical Biochemistry Tests in Patients with COVID-19 Infection.; 2020. Accessed September 18, 2023. https://www.rcpath.org/uploads/assets/3f1048e5-22ea-4bda-953af20671771524/G217-RCPath-guidance-on-use-and-interpretation-of-clinical-biochemistry-tests-in-patients-with-COVID-19-infection.pdf
World Health Organisation. WHO Guideline on Use of Ferritin Concentrations to Assess Iron Status in Individuals and Populations.; 2020. Accessed September 18, 2023. https://www.who.int/publications/i/item/9789240000124
From Fear to Freedom: A QC Data Management Revolution
What if we told you we had a solution to the multitude of monotonous hours spent analysing reams of IQC data and could provide you with an intuitive tool packed with comprehensive and customisable reports, interactive charts, and automated statistical analysis to help improve your QC data management?
Perhaps it sounds too good to be true?
This time, it isn’t.
Uncertainty of Measurement. 6Sigma. QC Multi-rules. These words can strike fear into the hearts of even the most experienced laboratory staff.
With Acusera 24.7, we’ve reached under the bed and forced the monster that is advanced statistical analysis out into the cold.
Acusera 24.7 is a live, cloud-based, interlaboratory QC data management and peer group comparison software.
A mouthful. I know.
But let’s break it down
A live, cloud-based software means you can access your QC data from anywhere, anytime.
Bid farewell to the labyrinth of folders you hunt through when troubleshooting or looking for a specific dataset.
Interlaboratory management describes the momentous task many QC managers face – monitoring the QC performance of multiple laboratories in different locations, ensuring they all maintain the high standards required for accreditation and accurate patient results.
Unlike some big-name subscription services, we encourage you to use our software at different locations to help you monitor all your laboratories and instruments to see how their results stack up against one another.
Acusera 24.7 provides multiple levels of access which are completely customisable. This allows you to grant or restrict access to different parts of the software depending on what is required by your staff. This also allows QC managers to view data from all their sites in one location without needing multiple email chains from each laboratory.
Peer group comparison? Isn’t that what EQA is for?
Well, you would be right.
Yes, EQA does provide a comparison with your peer group, but it doesn’t have exclusive rights.
There are many benefits to comparing your IQC data with your peer group. The real-time comparison data aids with troubleshooting, or you can show off how great you are to your friends and colleagues.
You can select your peer group for an instrument, method and more, providing you with a comprehensive picture of how your laboratory performance compares to your peers using the same lot of control.
There are no submission deadlines. One less thing for you to worry about.
Still think it sounds too good to be true?
Then let’s look at some of the software features and how they can be used to make your daily QC data management easier.
Charts
For many laboratories, review of their QC data is a momentous task involving an abundance of printouts with different data tables and graphs and hastily scribbled notes going back maybe months, if not years.
With Acusera 24.7’s interactive Levey-Jennings charts, you can see the QC data from a specified date range. This helps visualise trends and biases over any period to simplify the troubleshooting and lot validation processes, or, can be used as evidence during accreditation assessments. These charts can be generated for a single analyte or for multiple analytes and QC levels.
You can also add events to the graph to record factors that might impact the performance of your analyser such as preventive maintenance, calibrations or switching QC lots. So, when you come to review the QC data and see a shift in the results, you can see at a glance if there was an explanation for the change in QC results.
What’s more, the points plotted on the chart will appear in orange or red if they trigger your alert or reject protocols respectively. Those that appear as a triangle indicate a comment is attached. Comments can be added to any data point directly on the Levey-Jennings chart, allowing you to record any information relevant to the data, saving you time, not to mention the cost of all those sticky notes.
This complements the Panel feature of the software. Within Acusera 24.7 you can create a panel of tests, for example, a Liver Function Test panel, grouping all the tests together. You can then view all the QC data for this panel at the click of a few buttons. Shown below is the collective data for a clinical chemistry panel.
When you do need the paper copy, all the charts and reports found in Acusera 24.7 can be exported to Excel or PDF for independent analysis or printing, making it easy to bring your data to meetings or for hardcopy filing and audits.
For peer group comparison, you can get a performance summary chart. This chart basically does the analysis for you! You define the date and time range, and the software looks at all the data points within it for you and your peer group, comparing individual data, means, CVs and SDs. Like our other charts, you can combine any number of these for multi-analyte analysis.
Advanced Statistics
Some people love statistics. Others can think of nothing worse.
Either way, there’s a lot of work involved in advanced statistical analysis.
Even if you’re in the love camp, you might find yourself sickened before you’ve finished this metaphorical jar of marmite.
The role of a pathology laboratory is not to run QC and show off their statistical skills, but to provide accurate and appropriate patient results.
As the old saying goes, time is money.
But in your case, time is the difference between a fast or delayed diagnosis for a patient.
This may impact their condition or treatment.
By making use of the suite of statistical options included in Acusera 24.7, including QC Multi-rules, 6Sigma and Uncertainty of Measurement, you can focus on providing the most accurate and efficient testing for patients.
Data Entry
To save even more time, Acusera 24.7 can be integrated with many LIMS or Middleware packages for fully automated data transfer. At a predefined time, your internal software will send your QC data to a shared folder on your network and from there to a Randox Cloud IP address, meaning we don’t go into your IT system and take anything; we won’t cause any information security problems. This data is then taken from the cloud and populated onto 24.7.
All this in less time than it takes you to say, ‘fully automated data transfer.’
You can also import your data through a semi-automated upload procedure. For this, the data is exported from your LIMS or middleware and imported manually to your Acusera 24.7 account using an EDI import file. Simply put, all you have to do is send the file, and the software will populate it onto the system. Alternatively, you can upload the data manually on the simple and intuitive data entry page.
Acusera 24.7, while comprehensive and initially daunting due to its vast array of features, is incredibly easy to use. The Acusera 24.7 and QC operations teams are always eager to help new and existing Acusera 24.7 users with any issues they experience. We provide complete onboarding assistance and full training on the software for new customers while delivering prompt and effective customer support for existing users.
We’ve only begun to cover the range of features available on Acusera 24.7 for QC data management! For more information or to arrange a demo, get in touch with our team at marketing@randox.com. Or, you can take a look at our website here.
Sexual Health Week
September 11th-17th is Sexual Health Week
Sexual Health is a very important part of our lives, impacting on our wider physical and emotional well-being. In our relationships it is also important to act responsibly and with care – and to reduce the risk of Sexually Transmitted Infections (STIs).
More than one million sexually transmitted infections (STIs) are acquired every day worldwide, the majority of which are asymptomatic. STIs are on the increase, and many show very little to no symptoms.
We want to break the stigma on sexual health testing. Regular testing is what keeps us safe and prevents STI’s spreading. Regular screening can aid in detecting an infection in the early stages and help to reduce the risk of further complications.
Gonorrhoea and Syphilis, which are two of the most common STIs are increasing at alarming rates.
Usually treated easily with antibiotics, many STIs can cause serious health issues if left untreated. Chlamydia and Gonorrhoea can cause infertility and pelvic inflammatory disease, while syphilis can cause serious, irreversible, and potentially life-threatening problems with your brain, heart, or nerves. Sexually transmitted infections are on the increase, many of which present little to no active symptoms.
Blood Pressure Awareness Week
4th – 10th September is this years Blood Pressure Awareness week, also known as ‘Know your numbers week.’
It is estimated that 16 million people in the UK have high blood pressure, but around a third are unware that they have it – if left untreated, it can often cause heart attacks or stroke and is also a risk factor for heart disease, kidney disease and vascular dementia.
People with High Blood often show no symptoms but awareness of it can make it easily treatable and manageable.
Your blood pressure is an essential part of the successful circulation of blood around your body. When your heart contracts, it propels blood outward with force, circulating it around all the arteries in your body.
When healthy and relaxed, your arteries are flexible and provide just the right amount of resistance to enable efficient blood flow.
But what does that mean exactly?
High blood pressure is the result of the stiffening and constriction of your arteries. These narrower, more rigid arteries cause higher resistance to blood flow, ultimately causing the heart to work harder to pump the blood to the farthest parts of you.
Over time, this additional work can cause damage to the myocardium, or heart muscle, as well as other organs like the brain and kidneys. Know Your Numbers Week, organized by Blood Pressure UK, is an annual event in September that aims to increase awareness of the dangers of high blood pressure, promote the importance of knowing your blood pressure and provide you with information on how you can help lower yours.
Home testing kits have made it easy and convenient for people to test for health concerns from the comfort of their own homes – this allows them to begin taking steps to target at-risk areas. Home monitoring is both an effective and inexpensive way to keep blood pressure under control.
With Randox Health’s easy-to-use Heart Health home testing kit you can find out your cholesterol levels from the comfort of your home. This health test is available from £29 and measures total cholesterol, HDL (good) cholesterol. LDL (bad) cholesterol and triglycerides.
Our easy-to-interpret Heart Health report will provide a breakdown of your results.
Available at www.randoxhealth.com
Differentiating Viral from Bacterial Infections
Estimates claim that over 1.2 million people died in 2019 as a direct result of an antibiotic-resistant bacterial infection. Statistics show that up to 4.95 million deaths in the same year were associated with antimicrobial resistance (AMR)1. The overuse and misuse of antibiotics is considered to be the largest contributing factor to the rise of AMR. Antibiotics are effective at treating a wide range of bacterial infections, however, when used to treat viral infections, they have little to no effect. Even still, many physicians continue to prescribe so-called empirical antibiotics as an all-encompassing treatment strategy. In their defence, differentiating viral from bacterial infections can be troublesome. Traditional testing takes the form of paired serology, which requires patients to visit a healthcare facility twice during a 2–4-week period. Many of these infections have distressing symptoms, making this an unreasonable time-to-diagnosis period. Novel molecular techniques can reduce the time to result in the determination of many infections. However, some of these methods are associated with high false positive rates and low specificity resulting in further misuse of antibiotics.
Mxyovirus resistance protein A (MxA) is a biomarker associated with viral infections. It displays antiviral activity against positive, double-stranded RNA viruses and some DNA viruses2. In a study from earlier this year, MxA was used to differentiate viral from bacterial infections in a cohort of 61 adults with an AUROC of 0.9 and a sensitivity and specificity of 92.3% and 84.6% respectively3. An additional study, known as the TREND study, found that a cut-off of 430μg/L could effectively differentiate bacterial and viral infections with an AUROC of 0.9, a sensitivity of 92% and a specificity of 100%4.
C-reactive protein (CRP) is a non-specific acute phase protein which is associated with bacterial infection. However, CRP levels have also been shown to be elevated in response to various viral infections such as Influenza virus, malaria5 and SARS-COV-26, limiting its utility in differentiating the aetiology of an infection.
Using both biomarkers in combination can help physicians determine the true aetiology of infection with high specificity, supporting antimicrobial stewardship and reducing the harmful use of these drugs. Available on the VeraSTAT, Randox provides tests for MxA and CRP, which together provide a fast and accurate method of detection and differentiation of bacterial and viral infections from a small sample.
We have provided an educational guide which describes these biomarkers and their usefulness in the arena of viral and bacterial detection. If you’re interested in learning more, you can find our educational guide here.
Differentiating Viral from Bacterial Infections
Alternatively, don’t hesitate to browse our range on our website or get in touch with one of our team at marketing@randox.com who will be happy to help with any query you have!
References
- Murray CJL, Ikuta KS, Sharara F, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022;399(10325):629-655. doi:10.1016/S0140-6736(21)02724-0
- Liao S, Gao S. MxA: a broadly acting effector of interferon-induced human innate immunity. Visualized Cancer Medicine. 2022;3:2. doi:10.1051/vcm/2022002
- Metz M, Gualdoni GA, Winkler HM, et al. MxA for differentiating viral and bacterial infections in adults: a prospective, exploratory study. Infection. Published online February 3, 2023. doi:10.1007/s15010-023-01986-0
- Rhedin S, Eklundh A, Ryd-Rinder M, et al. Myxovirus resistance protein A for discriminating between viral and bacterial lower respiratory tract infections in children – The TREND study. Clinical Microbiology and Infection. 2022;28(9):1251-1257. doi:10.1016/j.cmi.2022.05.008
- Joseph P, Godofsky E. Outpatient Antibiotic Stewardship: A Growing Frontier—Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use. Open Forum Infect Dis. 2018;5(2). doi:10.1093/ofid/ofy024
- Paranga TG, Pavel-Tanasa M, Constantinescu D, et al. Comparison of C-reactive protein with distinct hyperinflammatory biomarkers in association with COVID-19 severity, mortality and SARS-CoV-2 variants. Front Immunol. 2023;14. doi:10.3389/fimmu.2023.1213246
MSc Health Data programme receives Randox scholarship
The University of Exeter’s MSc Health Data Science programme has received £25,200 from Global Diagnostics company Randox Laboratories to support two places on the programme.
The Randox Health Data Science Scholarship will enable successful applicants to gain access to world-class teaching, in an emerging field of Health Data Science at Exeter, as well as the opportunity to interact with specialists at Randox Laboratories during their masters.
The MSc Health Data Science course at Exeter is designed to equip students with innovative skills needed to tackle some of the biggest health challenges across the world. The programme also teaches the application of quantitative skills such as computing, mathematics, and statistics in the understanding of disease prevention and cure.
Exeter is one of only six UK universities to deliver the MSc Health Data Science programme.
The Scholarship is open to home students only and offers:
- Course fees (on a part-time or a full-time basis), or an equivalent contribution to living expenses.
- The opportunity to visit Randox in Belfast for two placements during the program, including a presentation to the company.
- The opportunity to partner with Randox on your dissertation project which forms an integral part of course credits.
- A Randox internship offer upon completion of studies to gain vital experience and insights into the field of diagnostics health care.
Professor Tim Frayling, programme lead for MSc Health Data Science, said: “The emerging field of data science is changing how we think about everything, including healthcare. There is huge competition for the most gifted students, and we need to encourage talented individuals to develop their skills and meet this demand.
“We are grateful to Randox for this generous donation of the scholarships to support two students who will have the opportunity to advance their knowledge in a vibrant field of health research.”
Dr. Helena Murray, Randox R&D Manager and programme lead for Health Data Science said: “We are in no doubt of the critical importance of Health Data Science as healthcare organisations seek earlier and reliable diagnosis from multiple health data points – many more than can be processed reliably at an individual level. This science offers the opportunity to both greatly improve healthcare outcomes and reduce the burden on healthcare services. There are clearly significant career opportunities in this field.
“We congratulate Exeter University on their Health Data Science programme and look forward to engaging with the successful candidates.”
Randox scholarships are additionally available to prospective eligible MSc Health Data Science students, according to the OfS criteria. The deadline for applications is August 14th 2023.