FeedbackBeginning September 11, 2007 the Clinical Laboratories of John Muir Health will complete the conversion of all of its chemistry and immunochemistry assays (> 70 tests) to a single new platform. This change to Beckman Coulter instrumentation is made because of the end of the expected life (5+ years) of our current excellent analyzers from Dade Behring and Diagnostic Products Corp (DPC), and represents one more step of our transition to total laboratory automation and a new state-of-the-art core laboratory. The Core Lab is currently under construction and is slated for completion and occupancy in the first quarter of 2008.
With the new instrumentation comes different reagent and detection systems, thus the need to reevaluate reference ranges for each of the assays. While the majority of tests show no significant difference, the enzymes and certain colorimetric tests do differ. Listed below are the results of extensive correlation and reference range studies of the new vs. old platforms for those assays that change significantly.
New = Slope x Old + Intercept
| Analyte | Slope | Intercept | Adult Old Ref Range |
Adult New Ref Range |
|---|---|---|---|---|
| Alk phos. | 0.8 | +4.4 | 50-136 | 35-115 |
| ALT | 0.9 | -14.5 | 30-65 | M: 10-63 F: 10-54 |
| Amylase | 1.3 | +9.5 | 25-115 | 30-140 |
| Creatine Kinase | 1.1 | +2.5 | M: 35-232 F: 21-215 |
M: 49-397 F: 38-234 |
| CK-MB | 1.0 +1.5 | 0-5 | 0-6.3 | |
| CK-MB % Relative Index |
0-4.0 | 0-3.0 | ||
| GGTP | 0.7 | +4.9 | M: 15-85 F: 5-55 |
M: 5-65 F: 5-55 |
| LDH | 100-190 | 100-210 | ||
| Lipase | 0.2 | -11.5 | 114-286 | 15-51 |
| Iron | 35-150 | M: 45-182 F: 28-170 |
||
| TIBC | M: 260-400 F: 260-445 |
250-450 | ||
| Uric Acid | M: 3.5-7.2 F: 2.6-6.0 |
M: 4.8-8.7 F: 2.6-8.0 |
For each analyte, sex-specific reference ranges have been validated for adults. Considerable collaboration with Children's Hospital Oakland and UC Davis Medical Center, supplemented with literature reviews, has led to assigning age-specific reference range values for pediatrics and adolescents as well. Thus for each assay, lab reports will display the appropriate age and sex-specific reference range for each patient.
As always, if there any questions or concerns, please do not hesitate to contact Barry Latner, M.D. (925) 692-5405, or Connie Houser or Pat Sinz in the Clinical Laboratory at MuirLab (925) 692-5631. Thank you.
