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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item The European Biological Variation Study (EuBIVAS): a summary report(WALTER DE GRUYTER GMBH, 2022-01-01) Carobene, Anna; Aarsand, Aasne K.; Bartlett, William A.; Coskun, Abdurrahman; Diaz-Garzon, Jorge; Fernandez-Calle, Pilar; Guerra, Elena; Jonker, Niels; Locatelli, Massimo; Plebani, Mario; Sandberg, Sverre; Ceriotti, FerruccioBiological variation (BV) data have many important applications in laboratory medicine. Concerns about quality of published BV data led the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) 1st Strategic Conference to indicate need for new studies to generate BV estimates of required quality. In response, the EFLM Working Group on BV delivered the multicenter European Biological Variation Study (EuBIVAS). This review summarises the EuBIVAS and its outcomes. Serum/plasma samples were taken from 91 ostensibly healthy individuals for 10 consecutive weeks at 6 European centres. Analysis was performed by Siemens ADVIA 2400 (clinical chemistry), Cobas Roche 8000, c702 and e801 (proteins and tumor markers/hormones respectively), ACL Top 750 (coagulation parameters), and IDS iSYS or DiaSorin Liaison (bone biomarkers). A strict preanalytical and analytical protocol was applied. To determine BV estimates with 95\% CI, CV-ANOVA after analysis of outliers, homogeneity and trend analysis or a Bayesian model was applied. EuBIVAS has so far delivered BV estimates for 80 different measurands. Estimates for 10 measurands (Non-HDL Cholesterol, S100-beta protein, neuron-specific enolase, soluble transferrin receptor, intact fibroblast growth-factor-23, uncarboxylated-unphosphorylated matrix-Gla protein, human epididymis protein-4, free, conjugated and \%free prostate-specific antigen), prior to EuBIVAS, have not been available. BV data for creatinine and troponin I were obtained using two analytical methods in each case. The EuBIVAS has delivered high-quality BV data for a wide range of measurands. The BV estimates are for many measurands lower than those previously reported, having an impact on the derived analytical performance specifications and reference change values.Item Within- and between-subject biological variation data for tumor markers based on the European Biological Variation Study(WALTER DE GRUYTER GMBH, 2022-01-01) Coskun, Abdurrahman; Aarsand, Aasne K.; Sandberg, Sverre; Guerra, Elena; Locatelli, Massimo; Diaz-Garzon, Jorge; Fernandez-Calle, Pilar; Ceriotti, Ferruccio; Jonker, Niels; Bartlett, William A.; Carobene, Anna; Chem, European Federation ClinicalObjectives: Reliable biological variation (BV) data are required for the clinical use of tumor markers in the diagnosis and monitoring of treatment effects in cancer. The European Biological Variation Study (EuBIVAS) was established by the EFLM Biological Variation Working Group to deliver BV data for clinically important measurands. In this study, EuBIVAS-based BV estimates are provided for cancer antigen (CA) 125, CA 15-3, CA 19-9, carcinoembryonic antigen, cytokeratin-19 fragment, alpha-fetoprotein and human epididymis protein 4. Methods: Subjects from five European countries were enrolled in the study, and weekly samples were collected from 91 healthy individuals (53 females and 38 malesItem European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates for serum thyroid biomarkers based on weekly samplings from 91 healthy participants(WALTER DE GRUYTER GMBH, 2022-01-01) Bottani, Michela; Aarsand, Aasne K.; Banfi, Giuseppe; Locatelli, Massimo; Coskun, Abdurrahman; Diaz-Garzon, Jorge; Fernandez-Calle, Pilar; Sandberg, Sverre; Ceriotti, Ferruccio; Carobene, Anna; Chem, European Federation ClinicalObjectives Thyroid biomarkers are fundamental for the diagnosis of thyroid disorders and for the monitoring and treatment of patients with these diseases. The knowledge of biological variation (BV) is important to define analytical performance specifications (APS) and reference change values (RCV). The aim of this study was to deliver BV estimates for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), thyroglobulin (TG), and calcitonin (CT). Methods Analyses were performed on serum samples obtained from the European Biological Variation Study population (91 healthy individuals from six European laboratoriesItem The European Biological Variation Study (EuBIVAS): Biological Variation Data for Coagulation Markers Estimated by a Bayesian Model(OXFORD UNIV PRESS INC, 2021-01-01) Aarsand, Aasne K.; Kristoffersen, Ann Helen; Sandberg, Sverre; Stove, Bard; Coskun, Abdurrahman; Fernandez-Calle, Pilar; Diaz-Garzon, Jorge; Guerra, Elena; Ceriotti, Ferruccio; Jonker, Niels; Roraas, Thomas; Carobene, Anna; Chem, European Federation ClinicalBACKGROUND: For biological variation (BV) data to be safely used, data must be reliable and relevant to the population in which they are applied. We used samples from the European Biological Variation Study (EuBIVAS) to determine BV of coagulation markers by a Bayesian model robust to extreme observations and used the derived within-participant BV estimates {[}CVP(i)] to assess the applicability of the BV estimates in clinical practice. METHOD: Plasma samples were drawn from 92 healthy individuals for 10 consecutive weeks at 6 European laboratories and analyzed in duplicate for activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, D-dimer, antithrombin (AT), protein C, protein S free, and factor VIII (FVIII). A Bayesian model with Student t likelihoods for samples and replicates was applied to derive CVP(i) and predicted BV estimates with 95\% credibility intervals. RESULTS: For all markers except D-dimer, CVP( i) were homogeneously distributed in the overall study population or in subgroups. Mean within-subject estimates (CVI) were <5\% for APTT, PT, AT, and protein S free, <10\% for protein C and FVIII, and <12\% for fibrinogen. For APTT, protein C, and protein S free, estimates were significantly lower in men than in women <= 50 years. CONCLUSION: For most coagulation markers, a common CVI estimate for men and women is applicable, whereas for APTT, protein C, and protein S free, sex-specific reference change values should be applied. The use of a Bayesian model to deliver individual CVP(i) allows for improved interpretation and application of the data.Item The European Biological Variation Study (EuBIVAS): weekly biological variation of cardiac troponin I estimated by the use of two different high-sensitivity cardiac troponin I assays(WALTER DE GRUYTER GMBH, 2020-01-01) Ceriotti, Ferruccio; Diaz-Garzon Marco, Jorge; Fernandez-Calle, Pilar; Maregnani, Alessio; Aarsand, Aasne K.; Coskun, Abdurrahman; Jonker, Niels; Sandberg, Sverre; Carobene, Anna; Chem, European Federation ClinicalBackground: Cardiac troponins (cTn) are specific markers for cardiac damage and acute coronary syndromes. The availability of new high-sensitivity assays allows cTn detection in healthy people, thus permitting the estimation of biological variation (BV) of cTn. The knowledge of BV is important to define analytical performance specifications (APS) and reference change values (RCVs). The aim of this study was to estimate the within- and between-subject weekly BV (CVI, CVG) of cTnI applying two high-sensitivity cTnI assays, using European Biological Variation Study (EuBIVAS) specimens. Methods: Thirty-eight men and 53 women underwent weekly fasting blood drawings for 10 consecutive weeks. Duplicate measurements were performed with Singulex Clarity (Singulex, USA) and Siemens Atellica (Siemens Healthineers, Germany). Results: cTnI was measurable in 99.4\% and 74.3\% of the samples with Singulex and Atellica assays, respectively. Concentrations were significantly higher in men than in women with both methods. The CVI estimates with 95\% confidence interval (CI) were for Singulex 16.6\% (15.6-17.7) and for Atellica 13.8\% (12.7-15.0), with the observed difference likely being caused by the different number of measurable samples. No significant CVI differences were observed between men and women. The CVG estimates for women were 40.3\% and 36.3\%, and for men 65.3\% and 36.5\% for Singulex and Atellica, respectively. The resulting APS and RCVs were similar for the two methods. Conclusions: This is the first study able to estimate cTnI BV for such a large cohort of well-characterized healthy individuals deriving objective APS and RCV values for detecting significant variations in cTnI serial measurements, even within the 99th percentile.Item Biological variation of serum iron from the European biological variation study (EuBIVAS)(WALTER DE GRUYTER GMBH, 2022-01-01) Carobene, Anna; Aarsand, Aasne K.; Coskun, Abdurrahman; Diaz-Garzon, Jorge; Locatelli, Massimo; Fernandez-Calle, Pilar; Sandberg, Sverre; Ceriotti, Ferruccio; Chem, European Federation Clinical