Randox Toxicology: Highest Percentage of Class A Drug Use in over a Decade

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Randox Toxicology: Highest Percentage of Class A Drug Use in over a Decade

Figures released by the Home Office from the Crime Survey of England and Wales for 2017/2018 showed an 8.4 percent rise in 16-24 year olds using Class A drugs in the last year, compared to 7 percent in 2016/2017. As drugs are becoming more readily available due to the Dark Web, mobile phones and drug gangs, a broader network of distribution has been established and the price of cocaine has fallen.

Cocaine is a strong stimulant that comes in a powder (known as coke), freebase or crack form. With short lived effects, cocaine temporarily speeds up the mind and body. Freebase is a powder cocaine that has been prepared for smoking, whilst crack cocaine comes in a rock form. As both forms of cocaine can be smoked, they reach the brain quicker and have a stronger effect than powder cocaine. Injecting any form of the drug has serious risks including, damaged veins and the spread of blood-borne viruses, such as HIV and Hepatitis C. High doses of cocaine can cause the body temperature to rise, resulting in convulsions, a heart attack and heart failure.

The Telegraph recently reported that the fall in cocaine prices has now led to the highest number of young people using Class A drugs in over a decade, a rise from 4.8 percent in 2012/2013. The United Nation’s 2018 World Drug Report states that the street price for a gram of cocaine in the UK in 2016 was £41, the cheapest figure documented at the time since 1990. Compare this to cocaine prices in 2007 when it was £69 per gram.

“Our young people’s services have seen a significant rise in the use of Class A drugs”. Yasmin Batliwala, chair of London based drug and alcohol treatment charity WDP commented on the issue, “The primary drug of choice has always been alcohol, as well as cannabis, but certainly in the last two or more years the use of Class A drugs has increased substantially.” When cocaine and alcohol have been mixed it can cause particularly dangerous side effects and produce a toxic chemical called cocaethylene.

We have the Solution!

Randox Toxicology’s universally available patented Biochip Array Technology boasts cutting-edge multiplex testing capabilities, providing rapid and accurate drug detection from a single sample. Offering excellent cross-reactivity and unrivalled limits of detection, Biochip Array Technology’s intra and inter assay precision is typically <10% giving excellent correlation with confirmatory methods.

Persistently staying ahead of the ever-changing trends, Randox Toxicology are first to market with a range of tests for drugs of abuse, including the cocaine metabolite Benzoylecgonine (BZG). Utilising our Biochip Array Technology, Randox Toxicology’s DoA I, DoA I+, DoA ULTRA/DUID, DoA Evolution and DoA MultiSTAT panels all detect Benzoylecgonine.

Built on a foundation of continuous innovation, our research and development team continue to advance the future of toxicology through pioneering technology and novel tests. Offering the most advanced screening technology on the market, Randox Toxicology has transformed the landscape of drugs of abuse testing forever.

If you would like to find out more information on our unrivalled toxicology test menu, email us at info@randoxtoxicology.com or visit www.randoxtoxicology.com

 

 

 

 

 


Randox Food Diagnostics: Feed Testing in the Meat Industry – Challenges and Solutions

The global meat industry is a multi-billion-dollar business contributing over $85 billion to the US economy alone annually. Globally it is valued at $800 billion and as such, it is one of the biggest industries in the world.

With its already strong position and an ever growing demand for meat products the market shows no sign of slowing down. There are continued demands set on producers to provide not only more meat, but meat at a higher quality. Public awareness on issues such as drug residues, animal rights, food safety and antibiotic resistance is on the rise and as such producers and processors are more and more required to meet stringent requirements.

With the increasing demand on quantity and quality the industry faces many challenges and one the key areas of interest in this production chain is the monitoring of residues.

Residues in food relates to the residual amount of a particular compound either administered to an animal as a veterinary treatment or a naturally occurring compound present in food for human consumption.

There are a number of potential issues that can arise from contaminated feed and it is important for producers to ensure that animal feed has little or no trace of residues of mycotoxins, growth promoters or veterinary drugs.

Veterinary drugs are often added to feed to be used as a method of treating livestock, producers therefore must be sure of the dosage to ensure that withdrawal periods are correctly adhered to. Mycotoxins may also be present in feed due to a number of environmental factors, this can have a negative impact of the livestock.

The Mycotoxin Threat

Mycotoxins are naturally occurring toxins produced by fungi, commonly known as moulds, which can have a harmful effect on humans and livestock. These moulds are of interest to producers because they have the potential for significant economic losses due to how they impact human health, animal productivity and international trading.

Mycotoxins can be present in a wide variety of foods and feeds and are a particular threat in areas with climates of high temperature and humidity. They can enter the food or feed chain through contaminated crops, in particular cereals, poultry meat and kidneys, pig kidneys and pork sausages. Contamination may also occur post-harvest during storage, transport, and processing stages of the food or feed supply chain.

The establishment of mycotoxin limits and regulations have been set by multiple food agencies worldwide.  For example the EU 2002-32 Directive sets maximum permitted levels (MPLs) for substances that are present in, or on, animal feed that have the potential to pose danger to animal or human health, to the environment, or could have an undesirable affect to livestock production.

One type of livestock that can be significantly impacted by mycotoxins are pigs. Pig feed contaminated with mycotoxins can cause serious risks to pig health.

For example, Aflatoxins consumed by swine can expose non-clinical characteristics with low level exposure (20 to 200 ppb), inducing symptoms displayed such as feed avoidance, gastrointestinal disturbances, paleness and slower growth. It can also suppress the immune system and cause young piglets to become more susceptible to bacterial, viral or parasitic diseases. With prolonged exposure causing a greater risk of cancer, liver damage and jaundice.  High concentrations of aflatoxin (1,000 to 5,000 ppb) result in acute effects, including death. It is a genotoxic carcinogen and suitably its levels have been set as low as realistically possible in complete feeding stuffs for pigs and poultry with a maximum content value of 0.02.

Zearalenone is another mycotoxin that can have a negative impact on livestock. Produced by a strain of Fusarium graminearum it has been listed under the Directive with a guidance value. It has an estrogeneous action and is significantly toxic to the reproductive system of animals with the potential to cause rectal and vaginal prolapses in gilts (young sows). Zearalenone has been allocated a suggested guidance value of 0.1ppm in complementary and complete feeding stuffs for piglets and gilts and 0.25ppm in feedstuffs for sows and fattening pigs.

With the risk from multiple Mycotoxins in animal feed it is important to be able to detect dangerous levels of each listed in the EU Directive in order to reduce instances of damage to animal health.

Growth Promoters

Growth promoters are often used in the meat industry to increase yield of livestock, an important tool considering the increased demand on quantity from the food chain. Some of these growth promoters however are known to have a negative impact on both animal and human health.

The presence of anabolic steroids including beta agonists such as Clenbuterol and Ractopamine, as well as other veterinary drugs is under a strict monitoring program in meat and animal feed to prevent these negative impacts.

Growth promoting drugs are used to induce weight but can have various health concerns such as such as hospitalisation with reversible symptoms of increased heart rate, muscular tremors, headache, nausea, fever, and chills.

The potential human health risks highlight the importance of complete food safety testing before a food product reaches the public.

Veterinary Drugs

Due to the nature of the conditions livestock is generally kept in, there is a high potential for infection and spread of viruses. Producers need to be aware and proactive in treating any veterinary disease that arises.

One such disease that can be an issue is coccidiosis which is a parasitic disease of the intestinal tract. This disease can be spread by contact with infected faeces, or the ingestion of infected tissues by other animals. Coccisiostats are potent drugs which are widely used within veterinary practice to treat coccidiosis, mainly in feed additives. Chickens are susceptible to at least 11 species of coccidia that causes coccidiosis therefore creating an importance to treat for. Coccisiostat residues that occur in high levels within food for human consumption can be unsafe and can have negative effects on pre-existing coronary conditions/diseases. These residues can pass through the meat tissue and eggs.

The Solution

With a variety of potential residues to be detected and a need for accurate results many producers are using Randox Food Diagnostics technology to carry out sample analysis.

With the development of the patented Biochip Array Technology Randox have consolidated the testing of multiple residues down to one sample which means time and cost saving for the meat industry. For example, with one Biochip a meat producer’s laboratory could test for 9 different growth promoter residues.

The technology centres on the Biochip, a 9mm2 ceramic chip which acts as the reaction well where samples are placed, requiring little technical expertise for preparation. Each chip is spotted with the antibodies required to detect the individual analytes being tested for and can accommodate up to 43 analytes. Food laboratories can then detect 43 different residues with one test.

The biochip works on the Evidence Investigator (Semi-Automated) and Evidence MultiSTAT(Automated) analysers. These analysers are used as the imaging stations for the biochips. Each spotted test site sends out a chemiluminescent signal which is detected by the analyser, processed, quantified and validated by the instrument software.

With a simple process, fast method and trusted results many of the world’s top meat producers are investing in Biochip Array Technology to ensure the safety and quality of their products.

For more information please contact us at: info@randoxfooddiagnostics.com.

 

 

 


RTS: Back-to-Lab Testing

Randox Testing Services offers high quality drug testing with use of our revolutionary Biochip Array Technology specifically optimised for drugs of abuse testing. This technology allows multiplex back-to-lab testing of different drugs from one sample and offers test consolidation for comprehensive testing at an affordable price.

With a comprehensive drugs of abuse test menu we are able to test for a range of different drugs. Drug testing packages can be customised to include multiple different drugs to test per sample.

Our drug testing methods ensure fast and simple sample collection. We have a variety of non-invasive methods for patient comfort including use of a urine sample, hair strand or oral fluid sample to test for specified drugs. Utilisation of different testing methods also ensures flexibility of drug abuse profiling with the ability to offer short-term drug abuse profiling via oral fluid and urine testing, long-term drug abuse profiling via hair testing or a combination of both.

 

Oral Fluid Testing

An oral fluid test can detect drugs for up to 48 hours after consumption. Providing analysis of short-term drug abuse, an oral fluid drug test is used by employers conducting for-cause and post-incident testing, as well as medico-legal solicitors who may require testing for abstinence of drugs.

An oral fluid test consists of obtaining a saliva sample from between the cheek and gums to analyse traces of drugs. This sample method is reliable due to the high concentrations of drug components which remain in the oral cavity for a period of time after drug consumption. Sample collection is taken quickly, easily and is non-invasive. The sample collection is also observed which ensures samples are not tampered with.

 

Urine Testing

A urine test offers short-term detection of substance abuse. Alcohol is detectable in urine for less than 12 hours, and a urine drug test can detect traces of drugs from between 4 hours and up to 8 days (this may be extended for regular cannabis users to around 30 days). It is often used in a combination with hair testing to provide an enhanced time-line for drug and alcohol detection; therefore allowing analysis of chronic substance abuse.

As a simple and practical method it is used as the most common sample type for workplace drug and alcohol testing. It is also utilised when conducting family law testing to ensure no alcohol intake by someone who has been forbidden to consume alcohol by a court of law or someone who is on a drugs or alcohol rehabilitation program.

A urine test consists of gaining a urine sample from the individual securely. Due to the nature of the urine sample being deposited privately by the sample donor, measures need to be taken to ensure the sample is not tampered with. At Randox Testing Services samples are collected under strict chain of custody protocols to guarantee sample integrity for legally defensible testing. We also increase accuracy of results by testing for creatinine which is a simple method of testing the authenticity of the sample given and reduces false-negative results giving you confidence in these testing methods.

Hair Testing

Hair testing is a long-term substance abuse profiling with a detection window of 90+ days. It is commonly used by recruiters and employers conducting pre-employment screening and is the most common sample type used for substance abuse assessment in child protection and medico-legal cases.

Hair testing involves taking a hair stand sample from an individual to detect if and approximately when someone has consumed drugs or alcohol. A 3cm sample is generally used to obtain a longer analysis of substance abuse.

When a drug is taken it is absorbed into the blood stream and circulated around the body. As a result it is incorporated into the hair follicle meaning that as the hair grows, drugs are transferred into the hair strand. It can take up to 2 weeks for drug components to enter the hair and therefore analysis of a 3cm sample is recommended.

Analysis of the hair strand allows traces of drugs to be detected to provide an overall picture of drug abuse or a month by month analysis. Segmentation of the hair sample to provide a detailed month-on-month view is advantageous as it can highlight trends of drug use and identify periods of abstinence or high level use. Body hair can be used in special circumstances however segmentation into a month by month analysis is not possible.

 

Randox Testing Services

Through utilising innovative multiplex drug and alcohol screening methods as well as LC/GC mass spectrometry confirmatory analysis our complete service guarantees reliable and accurate results.

For more information on our back-to-lab testing services contact us at testingservices@randox.com to speak with one of our experts.

 

 

 

 


Point of Care Testing (POCT) Explained

Point of Care Testing (POCT) Explained

Point of Care Testing (POCT) is the delivery of a test at the point in time at which the result will be used to make a decision and taking appropriate action resulting in an improved health outcome. It is also known as near patient, bed-side, extra-laboratory, decentralised, and ancillary testing [1]. It has been shown to reduce hospital stay time, reduce complications, and improve adherence to treatment [2].

Point of care testing is not a recent practice; many early diagnostic tests were administered at the bedside. However, analytical technology has progressed and multiple tests can be performed within minutes in a laboratory. Recently, this technology has been put into the hands of the staff near the patients [2]. There are two types of technology, benchtop analysers and hand held devices. Bench top systems are just smaller versions of laboratory analysers but some steps are automated. Hand held devices are simple in appearance but complex internally, they can manage several tasks including, adding reagents, separating cells from plasma, and reading colour or other measures.

BENEFITS OF POINT OF CARE TESTING

Results can be obtained faster, allowing for more immediate decisions meaning treatment can begin sooner. Patients can live a longer and higher quality life, helped by a reduction in the length of hospital stays.

Some benefits of POCT [2]:

•    Reduced number of clinic visits
•    Earlier discharge from hospital
•    Fewer unnecessary hospital admissions
•    Optimised drug treatment
•    More appropriate use of drugs
•    Reduced use of blood products
•    Reduced use of staff, equipment and space

Key objective

The main objective of Point of Care Testing is to generate results more quickly so that appropriate treatment can be provided, resulting in an improved patient outcome.

EFFECTIVE POINT OF CARE TESTING

Management

Accurate and reliable results can only be obtained if the patient and sample are treated correctly. Point of care testing is likely to be performed by staff with a limited technical background, so training and quality control are vital.

Outcomes

Proper analysis technique alone is not enough to ensure an accurate decision; any test will only be beneficial if the appropriate action is taken based on the result. The effectiveness of POCT is assessed in terms of the overall outcome of the patient.

WHERE DOES IT GO WRONG?

There are three phases in the POCT cycle: pre-analytical phase, analytical phase, and post-analytical phase. About 90% of quality issues are attributed to the pre-analytical and post-analytical phases [3]. These errors are mainly attributed to user error and can be caused by a number of issues including, selecting the wrong POCT device, not following manufacturer instructions, inadequate training, not adhering to appropriate QC practices, and many more.

The errors can usually be mitigated by implementing an action plan and ensuring it is executed exactly as designed, deviation from the action plan will lead to errors. Errors in POCT diagnostics can lead to misdiagnosis, improper treatment, costly follow-up procedures, and death.

Some strategies for improvement:

•    Ensure the POCT analyser is suitable for the kind of testing being undertaken
•    Ensure adequate QC to ensure your device is accurate and reliable
•    Develop a comprehensive training programme
•    Periodically carry out audits of POCT practices
THE NEED FOR QUALITY CONTROL

Internal Quality Control and External Quality Assessment is conducted to monitor the stability of the analytical measurement system and to alert the operator to a change that may lead to a medically significant error [6].

A study by Price, Smith and Bruel [8] was conducted on a number of labs over a period of time of up to 15 years. They discovered that test result performance improved with time and was associated with regular participation in External Quality Assessment (EQA) schemes and with the use of internal quality control (IQC) procedures.

Internal Quality Control

Internal Quality Control (IQC) is used to assess the day-to-day consistency of assay performance, providing quality assurance for patient results. IQC activities are among the ten most common POCT deficiencies. These may include performing and documenting quality control testing and taking the correct action for outliers [4]. This poor performance could be attributed to how IQC is viewed in POCT; users may lack appreciation of the potential for errors and may see the analyser as infallible, they likely see IQC as an additional workload as opposed to part of their testing routine.

CLSI regulations require risk assessment for each stage of patient testing alongside an implementation of a quality control plan. Below are some suggestions for how IQC should be conducted for POCT.

Conduct

IQC should be conducted when: a new lot of consumable is used; a patient result is queried; after maintenance; the device has been physically insulted. IQC should be conducted by the usual device operator so assurance can be provided for the whole testing process.

Training

ISO 22870 requires POCT users should be trained in the theory and practice of IQC [5]. Staff should be trained in every aspect of POCT including storage, preparation, frequency, documentation and basic troubleshooting.

Material

QC material for POCT should be obtained from a third party provider and not rely on material provided by the device manufacturer, the benefits of which are well documented. It should also contain analytes at clinically relevant concentrations, be provided ready-to-use, and be stable at ambient temperatures.

Results

All IQC results must be recorded with the date, time, user, decision to accept or reject, and any actions taken as appropriate. Locally assigned ranges alongside analyte-specific rules should be used to maximise error detection. An example of how IQC could be recorded and an action flowchart can be seen in Fig. A below.

Troubleshooting

There should be a protocol for required actions following a failed IQC. Any troubleshooting should be developed with knowledge of the most common errors and user capability.

Review

A monthly review should be conducted to identify persistent failures and trends.

The cost of IQC may also be a factor in resistance to IQC, however, while it is difficult to quantify, the cost of not conducting it may be greater in terms of human harm. A whitepaper is available detailing IQC in POCT (download).

Fig. A Examples of a manual IQC documentation, adapted from the Australian Government’s POCT General Practice [4]

Fig. A Examples of a manual IQC documentation, adapted from the Australian Government’s POCT General Practice  [4]. (Click to expand)

External Quality Assessment

External Quality Assessment (EQA) or Proficiency Testing (PT) involves running blind patient-like samples and comparing your results to peer results, in order to retrospectively monitor the accuracy of reporting. EQA samples should be treated as if they were a patient sample and therefore must be run by personnel who would normally use the device. This provides confidence in the reliability of patient test results. (Learn more about EQA)

Benefits of participation in an EQA programme include assessment of result accuracy, assessment over time, comparisons with instruments, methods and peers, and providing confidence in test results.

EQA for POCT is, in theory, similar to EQA in a large laboratory. There is a significant difference however, the POCT participants are usually health care professionals with little knowledge of laboratory medicine. A lack of understanding of the importance of EQA had led to a smaller percentage of sites participating than large laboratories.

A Good EQA Scheme

A good EQA scheme should offer:

•      Enables a comparison of performance between laboratories
•      Frequent reporting and rapid report turnaround time to minimise the amount of time an error can go unnoticed
•      High quality material in a format that works for you
•      Well-designed reports that allow for quick and easy troubleshooting of erroneous results at a glance
•      A sample matrix similar to a real patient sample
•      Large participant numbers to provide a large peer group to compare results to
•      A realistic range of analyte concentrations
•      Your entire range of tests in consolidated programmes, saving you time and money

“EQA should, as far as possible, cover the entire range of tests, and the entire examination process, from sample reception, preparation and analysis to interpretation and reporting.” [9]

ISO 15189

Conducting EQA in POCT

Below are some suggestions for how EQA should be conducted for POCT.

Conduct

EQA should be conducted by the operator who normally conducts patient testing to ensure the true workflow is assessed [6].

Material

EQA samples should be commutable, meaning they have the same numeric relationship between measurements procedures as is observed for a panel of patient samples (reacts the same as a real patient sample).

Report Frequency

Challenges / surveys should be frequent enough to identify systematic errors in a timely manner, affecting the fewest patient results [10].

Report Turnaround

A fast turnaround time allows test system errors to be identified sooner and necessary corrective actions to be taken immediately with minimum disruption to the lab.

Review

A regular review of past EQA results should be part of the cycle of quality.

Guidance

A POCT EQA provider should be able to provide assistance when the user is having difficulties.

Results

Individuals carrying out testing should have the correct knowledge to interpret results, choosing a scheme with easy to interpret results can help.

RANDOX POCT QUALITY CONTROL SOLUTIONS

Internal Quality Control

Randox offer a number of controls suitable for Point of Care Testing applications:

  • Acusera Blood Gas Control

    The Randox Acusera Blood Gas Quality Controls contain assayed target values for ten parameters, covering pH, pCO2, pO2, electrolytes, glucose and lactate. The material is provided in easy to open ampoules for added convenience and ease-of-use. The liquid ready-to-use nature of the control makes it ideal for use in point-of-care testing and on a wide range of blood gas instruments.

  • Acusera Liquid Cardiac Control

    The Randox Acusera Liquid Cardiac control is designed to be both convenient and easy to use. The liquid ready-to-use format makes it ideal for both clinical laboratories and point-of-care testing. Assayed, instrument specific values are provided for an impressive 8 cardiac markers including, NT-ProBNP, D-dimer and Troponin ensuring consolidation and flexibility. Furthermore, an open vial stability of 30 days for all analytes helps to keep waste and costs to a minimum.

  • Acusera Liquid HbA1c Control

    Conveniently supplied liquid ready-to-use the Liquid HbA1c control is ideally suited to both clinical laboratories and POCT helping to significantly reduce preparation time. With a stability of 30 days, waste and costs are also kept to a minimum.

  • Liquid Urine Control

    The Randox Acusera Liquid Urine quality control is designed to be both convenient and easy to use. The liquid ready-to-use format eliminates issues with pipetting and allows convenient storage at 2℃ – 8℃. Assayed instrument and method specific target values and ranges are provided for 18 commonly tested urine chemistry parameters.

External Quality Assessment

Randox offers RIQAS Point of Care, a simple EQA scheme designed for use in point of care settings. It is a single sample, single scheme programme featuring whole blood samples for authentic patient sample assessment.

Learn More
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RIQAS

RIQAS Point of Care

Acusera

References

[1] C. Price, A. St john and J. Hicks, “Point-of-care testing”, 2004. [Online]. Available: http://mldt.hu/upload/labor/document/PRICEP.pdf. [Accessed: 23- Jul- 2018].

[2] C. Price, “Point of care testing”, BMJ, vol. 322, pp. 1285-1288, 2001.

[3] A. Okorodudu, “Optimizing accuracy and precision for point-of-care tests”, Acutecaretesting.org, 2011. [Online]. Available: https://acutecaretesting.org/en/articles/optimizing-accuracy-and-precision-for-point-of-care-tests. [Accessed: 24- Jul- 2018].

[4] H. Holt and D. Freedman, “Internal quality control in point-of-care testing: where’s the evidence?”, Annals of Clinical Biochemistry, vol. 53, no. 2, pp. 233-239, 2016.

[5] “ISO 22870:2016 – Point-of-care testing (POCT) — Requirements for quality and competence”, Iso.org, 2018. [Online]. Available: https://www.iso.org/standard/71119.html. [Accessed: 25- Jul- 2018].

[6] J. Gill and M. Shephard, “The Conduct of Quality Control and Quality Assurance Testing for PoCT Outside the Laboratory”, Clin Biochem Rev., vol. 31, no. 3, pp. 85-88, 2010.

[7] A. Stavelin and S. Sandberg, “Essential aspects of external quality assurance for point-of-care testing”, Biochemia Medica, pp. 81-85, 2017.

[8] C. Price, I. Smith and A. Van den Bruel, “Improving the quality of point-of-care testing”, Family Practice, vol. 35, no. 4, pp. 358-364, 2017.

[9] “ISO 15189:2012 – Medical laboratories — Requirements for quality and competence”, Iso.org, 2018. [Online]. Available: https://www.iso.org/standard/56115.html. [Accessed: 31- Jul- 2018].

[10] J. Crilly, “Mythbusting: Frequency of EQA Reports”, Randox Laboratories, 2017.

[11] G. Kristensen and P. Meijer, “Interpretation of EQA results and EQA-based trouble shooting”, Biochemia Medica, pp. 49-62, 2017.


Importance of External Quality Assessment (EQA)

The Importance of External Quality Control

External Quality Assessment (EQA) / Proficiency Testing (PT) allows for a comparison of a laboratory’s testing procedures to other laboratories across the world. Comparisons can be made to a peer group of laboratories or to a reference laboratory.

EQA involves running blind patient-like samples, comparing your results to peer results, in order to retrospectively monitor the accuracy of reporting. EQA samples should be treated as if they were a patient sample and therefore must be run by personnel who would normally use the device. This provides confidence in the reliability of patient test results.

“EQA is defined as a system for objectively checking the laboratory’s performance using an external agency or facility.”
World Health Organisation (2009)
Benefits of EQA

Participating in an EQA scheme allows a laboratory to gather valuable data, this data can be used in a variety of ways [1]:

 

  • Enables a comparison of performance between laboratories.

     

  • Enables a comparison of performance between testing sites.
  • Provides an early warning for systematic errors.
  • Indicates areas for improvement.
  • Provides evidence of quality.
  • Identifies training areas.
  • Detects equipment faults, identify reagent problems and review staff training.
  • Compares performance to different analytical methods.

EQA provides assurance to both staff and customers that testing taking place at your laboratory provides accurate and reliable results. Problems can be identified early on and corrective action can be untaken. The reliability of methods, materials, and equipment can be evaluated and training can be developed and its impact monitored.

Large laboratory groups can compare their performance with sites across their group, ensuring accuracy and consistency no matter where testing takes place.

EQA participation is often a requirement for accreditation, gaining accreditation alone has a host of benefits, not least an increased confidence in results from customers, current and potential.

“Quality Control materials shall be periodically examined with a frequency that is based on the stability of the procedure and the risk of harm to the patient from an erroneous result” [2]
ISO 15189
Benefits of EQA in Point Of Care Testing (POCT)

Point of care testing (POCT) refers to testing that is performed near or at the site of a patient with the result leading to a possible change in the care of the patient. The popularity and demand for POCT has recently seen rapid growth, this comes from the advantages including the added convenience of being able to obtain a rapid result at the patient’s bedside, thus allowing immediate action, saving time and improving the potential outcome for the patient.

Although there are many benefits of using POCT devices in terms of their convenience, these benefits are only true if the results produced are both accurate and reliable. Ensuring accuracy and reliability is the primary responsibility of Quality Control.

EQA is strongly recommended for all point of care devices and is recommended by ISO 22870, which providesspecific requirements applicable to point-of-care testing and is intended to be used in conjunction with ISO 15189.

“There shall be participation in external quality assessment schemes” [3]
ISO 22870
WHAT MAKES A GOOD EQA SCHEME?

There are many External Quality Control schemes that come in different varieties. EQA schemes can be mandatory, required either by accreditation or law. Others are voluntary and carried out by laboratories who want to ensure that they are carrying out accurate testing and improve the quality of the lab’s performance [1].

A good EQA scheme should offer:

  • Enables a comparison of performance between laboratories.
  • Frequent reporting and rapid report turnaround time to minimise the amount of time an error can go unnoticed.
  • High quality material in a format that works for you.
  • Well-designed reports that allow for quick and easy troubleshooting of erroneous results at a glance.
  • A sample matrix similar to a real patient sample.
  • Large participant numbers to provide a large peer group to compare results to.
  • A realistic range of analyte concentrations.

     

  • Your entire range of tests in consolidated programmes, saving you time and money.
“EQA should, as far as possible, cover the entire range of tests, and the entire examination process, from sample reception, preparation and analysis to interpretation and reporting.” [2]
ISO 15189
LIMITATIONS OF EQA

EQA is a great tool for comparing against a peer group and maintaining an effective QC strategy, however, it has its limitations.

EQA / PT alone cannot provide a complete evaluation alone; it is important to also run third party controls regularly. You can find out about the importance of third party controls here.

EQA results can also be affected by variables not relating to patient samples, including preparation, clerical functions, matrix effects, and selection of method. The errors can appear to be a downside to EQA but it can be used as a way to evaluate staff performance as well as assay performance.

PARTICIPATING IN EQA

If possible, every laboratory should participate in an EQA scheme that covers all testing procedures. Laboratories need to develop a management process with the objective to assure that EQA samples are treated appropriately and in the same manner. This includes, sample handling, sample analysis, record keeping, investigating deficiencies, taking corrective actions, and communicating results with laboratory staff and management.

SOURCES OF ERROR

Problems at any stage of sample analysis can cause errors, when an error does happen, all elements of the process need to be checked. Some examples of errors:

Pre Analysis

•  Incorrect sample handling during preparation, shipping or storage

•  Improper storage

•  The material has expired

•  An error in manufacturing

Analysis

•  Instrument, calibration or reagent defects

•  Staff competency

•  Matrix effects

•  Incorrect analysis method

Post Analysis

•  Report misinterpretation

•  Clerical or transcription errors

•  Failure to take corrective action

QUICK SUMMARY
•  EQA is a system for objectively checking a laboratory’s performance using an external agency or facility [1].
•  Where possible, all laboratories should participate in an EQA scheme for all tests that they perform.
•  EQA samples should be treated in the same way as a patient sample, using the same procedures, instruments, methods, and staff who normally perform the testing.
• EQA provides valuable resources and data to effectively maintain accurate and reliable results and should be seen as educational.
RANDOX INTERNATIONAL QUALITY ASSESSMENT SCHEME (RIQAS)

Randox offers RIQAS, the largest EQA scheme in the world with over 45,000 participants across 133 countries, offering 33 consolidated programmes. Randox also offers a range of over 90 molecular programmes for infectious disease testing with Quality Control for Molecular Diseases (QCMD).

Features and Benefits

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Fully accredited to ISO/IEC 17043:2010

Outlines the general requirements for proficiency testing and demonstrates our commitment to quality.

 

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Consolidated programmes

Over 360 parameters in 33 comprehensive programmes, RIQAS streamlines EQA by reducing the number of programmes required.
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High frequency reporting

More frequent reporting allows for early detection of errors and allows corrective action to be taken much sooner, reports are retuned within 24-72 hours of the submission deadline.

 

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The highest quality material

All RIQAS programmes use the highest quality raw materials, this ensures that concentrations are clinically relevant and the sample performs like a real patient sample.
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User-friendly reports

RIQAS reports are presented in a simple one page per parameter format, facilitating performance assessment at a glance.

To learn more about RIQAS, visit the RIQAS homepage.

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RIQAS

RIQAS Point of Care

References

[1] WHO, Overview of External Quality Assessment (EQA). World Health Organisation, 2009.

[2] ISO 15189:2012 Medical laboratories — Requirements for quality and competence, 3rd ed. ISO, 2014.

[3] ISO 22870:2016 Point-of-care testing (POCT) — Requirements for quality and competence, 2nd ed. ISO, 2016.


RIQAS Point of Care – FAQs

RIQAS-POC-FAQ-Web-Banner Frequently Asked Questions

Why do I need to participate in an External Quality Assessment Scheme like RIQAS Point of Care?

Participation in an External Quality Assessment (EQA) scheme can help provide assurance and confidence that patient test results are accurate and reliable, therefore ensuring that the right clinical advice can be safely offered. Increasingly, commissioners of services like NHS Health Checks require assurance of satisfactory performance in an EQA scheme. In the UK, independent evidence of performance through participation in an EQA scheme is a requirement of the National Quality Assurance Advisory panel.

Read more about the importance and benefits of EQA

Is the RIQAS Point of Care scheme the right choice for us?

The RIQAS POC scheme is geared to assuring the quality of Point Of Care Testing in locations like pharmacies, General Practitioner surgeries, diagnostic/treatment and walk-in centres, sports clinics, and hospital out patients. Typically, the scheme is commissioned by a prime contractor (the client) on behalf of a chain of participants. The POC scheme complements the RIQAS scheme for laboratory-based analysers operated by specialist laboratory scientists.

Please contact us to determine which scheme is most suitable for your needs.

How many operators can be registered at each location?

As many as you wish. New operators can be added at any time, email addresses can be modified and the system is able to recognise operators who may be working at more than one location. In encouraging ownership responsibility for updates lies with the operators at each location.

What happens if we want to transfer an analyser to another location or replace an old analyser with a new one?

In order to participate in the next sample, distribution changes must be made before the 20th of each month. Participation contracts are renewable annually and new analysers can be added to the scheme at any time during the contract.

HOW LONG DO I HAVE TO PROCESS THE SAMPLE AND SUBMIT THE RESULTS?

Samples are typically distributed on the first Monday of the month, results should be submitted online via the RIQAS Point of Care software before 5pm the following Monday.  Please see the Distribution Timetable for further information.

HOW SHOULD I STORE MY SAMPLES?

Samples should be kept refrigerated at between 2-8oC.  Do not freeze.

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RIQAS Point of Care

RIQAS

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RTS: The Dangers of Psychoactive Substances

Psychoactive substances, formerly known as legal highs, are substances which produce the same or similar effects as many illegal drugs such as cannabis, ecstasy and cocaine. With many psychoactive substances it is extremely difficult to know their potency and therefore how they will affect the user.

They are divided into four main groups:

Sedatives – Cause reduced concentration and slowing of reactions, leading user to feel physically unsteady and lethargic.

Hallucinogenic – These substances cause psychedelic reactions which can lead the user to act erratically, putting their own safety at risk.

Stimulants – Substance temporarily causes increase in alertness and energy, while also putting a strain on the nervous system.

Synthetic Cannabinoids – Large doses can lead to life-threatening intoxication. Also effects the central nervous system causing seizures, high blood pressure, rapid heart rate and increased body temperature.

Incidents

Last month two men were arrested and jailed for four and a half years for selling psychoactive substances. The offences were committed in Scotland and eight of the men’s customers needed hospital treatment after taking the substances.

Free samples and loyalty cards were used by the men selling the psychoactive substances and two users were left in comas after taking a substance known as Psyclone. Court was told that the shops took in as much as £2,500 in sales every day.

The sister of a man who died from taking psychoactive substances said it changed her brother “mentally and physically.” BBC Scotland was told that he started dabbling with psychoactive substances because he believed they were legal. “Some of them were a substitute of heroin, others to mimic the effects of cannabis. He became very withdrawn with the family and just wanted to stay away.”

 

Randox Testing Services

At Randox Testing Services we reacted to the issues caused by psychoactive substances by releasing the world’s first Synthetic Cannabinoids (JWH/AM) and ‘Bath Salt’s’ (MPDV) tests in 2012. This enables companies to test for popular types of psychoactive substances and showed that it was possible to detect these substances.

However as new psychoactive substances emerged new tests also had to be created and next generation Synthetic Cannabinoids tests (UR144 and JWH250) were released in 2013. These tests represented a milestone in the fight against the highly dangerous psychoactive substances and provided a way for laboratories and companies to stay on top of the developing drug trends.

Psychoactive Substances we currently screen for;

 

 

 

 

 

 

Today, in the endless pursuit of creating innovative tests for new and emerging psychoactive substances, our expertise sets us apart from the rest of the industry. We will continue to develop our test menus and grow our range of tests.

For more information contact us today at testingservices@randox.com.

 

 

 

 

 


Biochip vs ELISA: Which testing platform is right for me?

Biochip Vs ELISA

Randox Toxicology’s latest video series, ‘Biochip Vs ELISA’, highlights our routine and novel ELISA products and how they differ from Biochip Array Technology.

Showcasing the journey and ongoing brand evolution of Randox Toxicology, these videos will help you to discover which method is right for you!

Episode 1: Meet ELISA

Episode 1 “Meet ELISA” uses speed reading to showcase Randox Toxicology’s extensive and ever-expanding ELISA test menu, including our range of New Psychoactive Substances, drugs of abuse, stimulants, analgesics and sedatives. Manufactured in the United Kingdom, our continuous reinvestment in research and development has enabled us to develop a range of exclusive ELISA kits such as, Mitragynine, MT-45, and U-47700 which was involved in the death of the famous singer Prince.

 

Our cost effective ELISA kits are the highest quality on the market and results provide excellent correlation with confirmatory methods, typically <10% CV.

Episode 2: Meet Biochip

Based on ELISA principles, Episode 2 “Meet Biochip” illustrates Biochip Array Technology as a solid-state device with discrete test sites onto which antibodies specific to different drug compounds are immobilised and stabilised. Moving away from traditional single analyte assays, Biochip Array Technology boasts cutting-edge multiplex testing capabilities for rapid and accurate drug detection from a single sample.

As the primary manufacturers of Biochip Array Technology, Randox Toxicology offer the most advanced screening technology on the market. With the world’s largest test menu capable of detecting over 500 drugs, Randox Toxicology are changing the landscape of drugs of abuse testing.

Episode 3: Biochip Vs ELISA

Episode 3 “Biochip Vs ELISA” gives you the opportunity to hear from a professional! Laura Keery our Senior Research and Development Team Leader gives you a behind the scenes look at our Biochip Array Technology and ELISA products in action at our new Science Park, answering some of those must know questions.

Episode 4: Biochip Vs ELISA 360-Degrees

If you missed it at SOFT-TIAFT 2017, our Biochip Vs ELISA 360-degree video allows you to experience Biochip and ELISA in action.

Discover which method is right for you! #biochipvselisa

For more information about our revolutionary Biochip Array Technology and ELISA kits, email info@randoxtoxicology.com or visit www.randoxtoxicology.com

 

 

 

 

 


Randox Testing Services | How can a policy form the basis of workplace drug & alcohol testing?

If you work in a company with safety-critical roles it is more than likely that you have some sort of workplace drug and alcohol testing policy in place. Even companies without safety-critical roles are implementing these policies to further ensure the health, safety and wellbeing of their staff.

Employers hold the responsibility to ensure employees are fully aware of the company’s rules, regulations, testing and disciplinary procedures.

The policy itself holds vital importance, providing employees with the knowledge of the standards expected of them, whilst educating themselves with information provided in a written comprehensive manner.

The importance of implementing a policy

The most important element of a workplace drug and alcohol testing policy is SAFETY. Drug and alcohol use increases the probability of workplace accidents occurring. Studies have found that employees who have alcohol problems are 2.7 times more likely to have an accident whilst at work. The main issues associated with substance misuse relate to:

  • Absenteeism – it’s estimated that 17 million days of work are lost per year due to substance misuse.
  • Low productivity levels – employees may reduce output in different tasks and become de-motivated.
  • Inappropriate behaviour – some cases of substance abuse may lead to crime.
  • Aggressive behaviour towards others – resulting in loss of employment / convictions

It’s evident that many who suffer from drug & alcohol abuse are in employment. Studies show 25% of those in employment were registered drug addicts with 3.3% of all adults aged 16-59 classified as frequent users.

Significant issues such as these provide growing concerns for employers to implement a workplace drug and alcohol policy, to ensure the welfare of each member of staff is considered. Under the Health & Safety Act 1874, employers have a responsibility to ensure the safety of their employees is fully met in order to maintain standards.

The importance of a workplace policy for drugs and alcohol can benefit employers by:

  • Building relationships with employees by showing there is help and support available.
  • Policies can raise awareness of issues in the business and can encourage staff members to take action if needed.
  • It can reduce the number of sick employees, reduce staff turnover and increase productivity levels.

Speak with us directly

We understand that the importance of having a policy that suits the specific needs of your company. In order to fully achieve this, we offer a free policy review service, where we will review your company’s existing documentation to gain an understanding of how we can help going forward.

We are delighted to announce we will be attending the Safety & Health Expo 2018. The annual event, running from 19th – 21st June and held at the Excel London, is the UK’s largest health and safety event with over 13,500 national and international key industry professionals across construction, manufacturing, government and consulting.

By attending this prestigious event we hope to engage with a range of stakeholders to discuss how our drug & alcohol testing services can have a positive impact on your employees and business.

If you are attending this event and would like to speak with us, please stop by our stand M410 to speak with one of our experts.

Alternatively, if you would like to arrange a meeting with us prior to the event, please email us: testingservices@randox.com, and quote Safety & Health Expo 2018 at the beginning of your message.

For more information on workplace drug & alcohol testing, visit www.randoxtestingservices.com.

 


Drug and Alcohol Testing in the Medico-legal Market

Medico-legal testing for drugs and alcohol may be required by various professional bodies involved in child custody cases, care proceedings or child protection cases. In cases regarding divorce and children, a dispute may arise during the process of discussions involving the custody of children. In these cases drug and alcohol testing may be sought if there has been a substance abuse claim against a parent fighting for custody or visitation. In cases relating to child protection, social services may seek drug and alcohol testing if child welfare claims have been made regarding suspected substance misuse.

Normally in medico-legal cases a hair sample would be tested as it provides the longest detection window.

 

Why is Drug and Alcohol Testing in Medico-legal Cases Important?

Drug and alcohol testing is important to ensure child protection from the detrimental effects of parental substance misuse and to ensure they have a quality of life they deserve. In addition it is also important to enable parents the opportunity to get the help and support they need and begin rehabilitation treatment.

Doing the right thing by the child is the main priority, and where possible parent and child relationships are sought to be maintained. Drug and alcohol testing assists in these efforts and in such cases abstinence monitoring testing may be required to assess a parent’s recovery e.g. if a visitation case is being reassessed.

 

Our Expertise

At Randox Testing Services we provide drug and alcohol testing to all professionals within the family law and medico-legal sector. Our hair drug testing service utilises accredited testing methods and is made more cost-effective through utilising patented testing methods developed by Randox.

We understand the impact a positive result can have on a parent, child, and extended family and ensure results of the highest precision and accuracy. With over 35 years’ experience in the diagnostic industry we have gained reputation as a trusted provider.

Our drug and alcohol testing solutions are flexible and can be tailored to our customer needs with a choice of testing methods. We offer a comprehensive drugs of abuse test menu and our service also includes expert witness reporting where applicable.

 

Contact Us

To speak to one of our experts about hair drug testing contact enquiries@randoxtesting.com or call +44 (0) 161 741 2760. We work with companies within the medico-legal sector along with a wide range of workplaces and also private individuals.

For further information on RTS, or to arrange interviews, please contact the Randox PR team via email: randoxpr@randox.com or phone 028 9442 2413


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