Araştırma Çıktıları
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Item Systematic review and meta-analysis of within-subject and between-subject biological variation estimates of 20 haematological parameters(WALTER DE GRUYTER GMBH, 2020-01-01) Coskun, Abdurrahman; Braga, Federica; Carobene, Anna; Tejedor Ganduxe, Xavier; Aarsand, Aasne K.; Fernandez-Calle, Pilar; Diaz-Garzon Marco, Jorge; Bartlett, William; Jonker, Niels; Aslan, Berna; Minchinela, Joana; Boned, Beatriz; Gonzalez-Lao, Elisabet; Marques-Garcia, Fernando; Perich, Carmen; Ricos, Carmen; Simon, Margarita; Sandberg, Sverre; Chem, European Federation ClinicalBackground: Interpretation of the complete blood count (CBC) parameters requires reliable biological variation (BV) data. The aims of this study were to appraise the quality of publications reporting BV data for CBC parameters by applying the BV Data Critical Appraisal Checklist (BIVAC) and to deliver global BV estimates based on BIVAC compliant studies. Methods: Relevant publications were identified by a systematic literature search and evaluated for their compliance with the 14 BIVAC criteria, scored as A, B, C or D, indicating decreasing compliance. Global CVI and CVG estimates with 95\% CI were delivered by a meta-analysis approach using data from BIVAC compliant papers (grades A-C). Results: In total, 32 studies were identifiedItem Critical review and meta-analysis of biological variation estimates for tumor markers(WALTER DE GRUYTER GMBH, 2022-01-01) Marques-Garcia, Fernando; Boned, Beatriz; Gonzalez-Lao, Elisabet; Braga, Federica; Carobene, Anna; Coskun, Abdurrahman; Diaz-Garzon, Jorge; Fernandez-Calle, Pilar; Carmen Perich, Maria; Simon, Margarida; Jonker, Niels; Aslan, Berna; Bartlett, William Alexander; Sandberg, Sverre; Aarsand, Aasne K.; Chem, European Federation Clinical; Database, Task Grp Biol VariationObjectives Biological variation data (BV) can be used for different applications, but this depends on the availability of robust and relevant BV data. In this study, we aimed to summarize and appraise BV studies for tumor markers, to examine the influence of study population characteristics and concentrations on BV estimates and to discuss the applicability of BV data for tumor markers in clinical practice. Methods Studies reporting BV data for tumor markers related to gastrointestinal, prostate, breast, ovarian, haematological, lung, and dermatological cancers were identified by a systematic literature search. Relevant studies were evaluated by the Biological Variation Data Critical Appraisal Checklist (BIVAC) and meta-analyses were performed for BIVAC compliant studies to deliver global estimates of within-subject (CVI) and between-subject (CVG) BV with 95\% CI. Results The systematic review identified 49 studies delivering results for 22 tumor markersItem 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 Long-term within- and between-subject biological variation of 29 routine laboratory measurands in athletes(WALTER DE GRUYTER GMBH, 2022-01-01) Diaz-Garzon, Jorge; Fernandez-Calle, Pilar; Aarsand, Aasne K.; Sandberg, Sverre; Coskun, Abdurrahaman; Carobene, Anna; Jonker, Niels; Itkonen, Outi; Bartlett, William A.; Buno, Antonio; Chem, European Federation ClinicalObjectives Within- and between-subject biological variation (BV) estimates have many applications in laboratory medicine. However, robust high-quality BV estimates are lacking for many populations, such as athletes. This study aimed to deliver BV estimates of 29 routine laboratory measurands derived from a Biological Variation Data Critical Appraisal Checklist compliant design in a population of high-endurance athletes. Methods Eleven samples per subject were drawn from 30 triathletes monthly, during a whole sport season. Serum samples were measured in duplicate for proteins, liver enzymes, lipids and kidney-related measurands on an Advia2400 (Siemens Healthineers). After outlier and homogeneity analysis, within-subject (CVI) and between-subject (CVG) biological variation estimates were delivered (CV-ANOVA and log-ANOVA, respectively) and a linear mixed model was applied to analyze the effect of exercise and health related variables. Results Most CVI estimates were similar or only slightly higher in athletes compared to those reported for the general population, whereas two- to three-fold increases were observed for amylase, ALT, AST and ALP. No effect of exercise and health related variables were observed on the CVI estimates. For seven measurands, data were not homogeneously distributed and BV estimates were therefore not reported. Conclusions The observation of higher CVI estimates in athletes than what has been reported for the general population may be related to physiological stress over time caused by the continuous practice of exercise. The BV estimates derived from this study could be applied to athlete populations from disciplines in which they exercise under similar conditions of intensity and duration.Item 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