Clinical Chemistry I Week 11: Automation & POC

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Questions and Answers

What is a characteristic advantage of disposable products in laboratory automation?

They eliminate the need for reagent handling.

They help carryover to a minimum. (correct)

They reduce the automation costs significantly.

They are environmentally friendly.

Which of the following is NOT a measurement approach used in laboratory automation?

Fluorometry

Electrochemical methods

Photometry

Gravimetric analysis (correct)

Which of the following processes involves mixing reactants in laboratory automation?

Specimen Processing

Reagent Handling

Thermal Regulation

Forceful dispensing (correct)

What is a crucial technician responsibility in maintaining laboratory analyzers?

Following manufacturer instruction for scheduled maintenance. Signup and view all the answers

In the context of laboratory automation, what is meant by 'signal processing and data handling'?

Computerized acquisition, processing, and storage of operational data. Signup and view all the answers

What is the main advantage of automation in clinical chemistry?

Improved efficiency and faster turnaround times Signup and view all the answers

Which analysis method allows for each specimen to be analyzed for different tests sequentially?

Random-access analysis Signup and view all the answers

What does the term 'throughput' refer to in the context of automation?

Number of specimens processed in a given timeframe Signup and view all the answers

In continuous flow analyzers, what is used to facilitate chemical reactions?

Tubing flow of reagents and samples Signup and view all the answers

What is a characteristic of discrete analyzers?

They separate samples and reagents in individual containers Signup and view all the answers

Which of the following is NOT a part of the automated workflow in the diagnostic laboratory?

Manual result interpretation Signup and view all the answers

What is meant by the term 'carry-over' in clinical chemistry?

Transport of analyte from one specimen to another Signup and view all the answers

Which analysis type involves processing specimens that enter the analytical process one after another?

Sequential analysis Signup and view all the answers

What does the term 'pre-analytical' refer to in a laboratory setting?

Actions done to a sample before analysis Signup and view all the answers

Which method of analysis allows multiple analytical processes to occur on a single specimen simultaneously?

Multiple-channel analysis Signup and view all the answers

Study Notes

Clinical Chemistry I - 0202304

Course instructor: Mohammad Qabajah
Email: [email protected]

Week 11: Automation & POC

Focus on automation and point-of-care (POC) testing in clinical chemistry.

Automation in Clinical Chemistry

Automation is the process where an analytical instrument performs multiple tests with minimal analyst involvement.
Automation is also the controlled operation of equipment, processes, or systems using mechanical or electronic devices without manual intervention.
Modern clinical labs heavily rely on automation.

Why Automation?

Increase laboratory capacity
Reduce errors
Faster turnaround time (TAT)
Optimize personnel use
Improve space utilization

Steps Automated in the Diagnostic Lab

Pre-analytical: Order preparation, sample collection, transport to lab, accessioning, centrifugation, decanting, pre-sort/aliquoting, transport to analyzer.
Analytical: Sample retrieval, sample storage, waste disposal, transmission results, technical validation.
Post-analytical: Processing, data handling, results transfer.

Definitions

Batch analysis: Multiple specimens grouped for analysis in a single session.
Random-access analysis: Sequential analysis where each specimen is analyzed independently, often for different tests.
Sequential analysis: Specimens analyzed one after the other in a batch, with results emerging in the same order.
Carry-over: Contamination of subsequent specimens or reactions from previous specimens due to residual analyte or reagents.
Multiple-channel analysis: Multiple tests performed simultaneously on a single specimen.
Single-channel analysis: Only one test or analyte is processed at a time on a single specimen.
Parallel analysis: Multiple processes happening concurrently.
Throughput: The number of specimens an analyzer processes within a set time.

Types of Analyzers

Continuous flow: Reagents and samples flow continuously through tubing.
Discrete: Separate containers for reagents and samples (e.g., centrifugal analyzers).

Continuous Flow

Samples are aspirated into tubes and then into the sample holder.
Reagents are brought into the system.
Chemical reactions are performed.
Samples are pumped into a flow-through cuvette for spectro-photometry.
Sample and air bubbles can be encountered through the system.
Samples are moved to the incubator and the reaction is performed.

Discrete Analyzers

Samples & reagents are kept in separate containers.
Multiple tests can be performed simultaneously (one after the other).
Minimizes carry-over.
Increased cost of disposable products..

Chemistry Analyzer Operations

Sample identification.
Defining the test(s).
Reagent systems & delivery.
Specimen measurement & delivery.
Chemical Reaction phase: Mixing of reagents & samples, incubated.
Measurement phase: Optical readings of reaction.
Signal processing & data handling: Analytes measured with a calibration curve.
Sending results to LIS.

Total Laboratory Automation

This involves connecting a variety of different devices and laboratory equipment.
There is a robotic interface (Sysmex), an online analyzer interface (J & J 950), specimen sorters, automated aliquotters, uncappers, recappers, refrigerated storage managers, automated centrifuges, and a transport system.

Specimen Preparation

Specimen processing is needed.
Specimen loading and aspiration are often part of the process.
Reagent handling and storage are crucial parts of automated systems.
Inventory management is important.
The system can be either open or closed depending on how it's integrated into the system.

Chemical Reaction Phase

Type of reaction vessels or cuvettes are used.
Time of reaction is important.
Mixing of reactants is important, as is forceful dispensing of chemicals
Magnetic stirring, vigorous lateral displacement, and rotating paddles help with mixing.
Ultra sonic energy can also be used.
Thermal regulation (temperature control) is essential.

Measurement Approaches

Photometry/spectrophotometry.
Reflectance photometry.
Fluorometry
Turbidimetry and Nephelometry
Chemiluminescence and Bioluminescence.
Electrochemical methods.

Signal Processing & Data Handling

Analyzer operation relies on computerized systems.
Electromechanical system operation.
Data acquisition, processing, and storage.
Interconnects with operator and mainframe computers.

Automation for the Clinical Laboratory

Automation is used in many types of laboratory testing, including chemistry, hematology, immunoassay, coagulation, microbiology, and nucleic acid testing..

Areas of Automation

Urine analyzers
Cell Counters
Nucleic Acid Analyzers
Microtiter Plate Systems
Automated Pipetting Stations
POCT (Point of Care Testing) Analyzers
Clinical chemistry analysers

Technician Responsibility

Technicians must follow manufacturer's instructions for scheduled calibrations and daily, weekly, and monthly maintenance.

Point-of-Care Testing (POCT)

Testing performed outside the lab, but within the institution.
Often carried out by non-laboratory personnel (physicians, nurses, respiratory technicians).

Place of Analysis

POCT can happen in the physician’s offices, operating rooms, emergency rooms, intensive care units, and home healthcare settings. Patients can also take on some testing tasks themselves where possible.

Personnel Issues

POCT is often carried out by people who are not lab professionals.
Those individuals may not have specific training in testing and interpretation.

Classification of POCT Instruments

Different types of POCT instruments, each with different measurement analysis methods.

Examples of POCT Devices

Different in-vivo, ex-vivo, and non-invasive POCT devices based on their method of analysis.

Troponin Measurement

An example of a POCT that is commonly used in cardiac diagnostics for early detection of heart attack.
Gold-labeled antibodies and biotinylated antibodies are used in the testing process.

Blood Gas Measurement

Optical sensors offer advantages over electrochemical sensors for blood gas measurement. They have calibration advantages.

HbA1c Measurement

An example of a POCT instrument for measuring HbA1c levels.
This particular example shows the cartridge, absorbent liquid pick-up, and reagent delivery components.

Laboratory Support

Lab personnel are still responsible for the results generated by these systems even though a variety of clinical staff may do a lot of the testing. This includes training and managing POCT programs in the institution.

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Description

This quiz covers the critical aspects of automation and point-of-care (POC) testing in clinical chemistry. It focuses on the benefits of automation in diagnostic labs, including reduced errors and faster turnaround times. Explore how automation enhances laboratory capacity and optimizes resources for better efficiency.