Skip to main content

Post-analytical Issues in the Clinical Laboratory

  • Chapter
  • First Online:
Clinical Core Laboratory Testing

Abstract

The final part of the laboratory testing process is known as the “Post-Analytical Phase.” In this phase, lab results are communicated to physicians. While the mechanisms of communication vary from verbal to digital, the end goal remains the same: provide accurate, timely, informative results to the physician. Although physicians are on the receiving end of this process, it may remain a bit of a black box. Common questions include: Why is this test taking so long? Why did the reference interval change since last time? Why is the lab calling me? How do I interpret a modest change in a result over time?

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Analytical imprecision refers to the amount of “wobble” there is in successive measurements of the same sample; for instance, if potassium were measured ten times in a row in a sample with a concentration of 3.5 mmol/L, measurements would range from ~3.4 to 3.6 mmol/L; see Chap. 4 .

References

  • American Association for Clinical Chemistry Pediatric Reference Range Initiative. http://www.aacc.org/resourcecenters/resource_topics/pediatric_reference_range/

  • Baer, D. M., Ernst, D. J., Willeford, S. I., & Gambino, R. (2006). Investigating elevated potassium values. MLO: Medical Laboratory Observer, 38(11), 24. 26, 30–31.

    Google Scholar 

  • Callum, G. (2001). Fraser biological variation: From principles to practice. Washington, DC: AACC Press.

    Google Scholar 

  • Canadian Laboratory Initiative on Paediatric Reference Intervals (CALIPER). http://www.caliperdatabase.com/caliperdatabase/controller

  • Cappellini, M. D., Brancaleoni, V., Graziadei, G., Tavazzi, D., & Di Pierro, E. (2010). Porphyrias at a glance: diagnosis and treatment. Internal and Emergency Medicine, 5(Suppl 1), S73–S80. doi:10.1007/s11739-010-0449-7.

    Article  Google Scholar 

  • CLSI Document H3-A4. (1998). Procedures for the collection of diagnostic blood specimens by venipuncture. Approved standard, 4th ed. Wayne, PA.

    Google Scholar 

  • Don, B. R., Sebastian, A., Cheitlin, M., Christiansen, M., & Schambelan, M. (1990). Pseudohyperkalemia caused by fist clenching during phlebotomy. The New England Journal of Medicine, 322(18), 1290–1292.

    Article  CAS  Google Scholar 

  • Ebell, M. H. (2003). Strep throat. American Family Physician, 68(5), 937–938.

    Google Scholar 

  • Fox, J. W., Cohen, D. M., Marcon, M. J., Cotton, W. H., & Bonsu, B. K. (2006). Performance of rapid streptococcal antigen testing varies by personnel. Journal of Clinical Microbiology, 44(11), 3918–3922. Epub 2006 Sep 13.

    Article  Google Scholar 

  • Gaylord, M. S., Pittman, P. A., Bartness, J., Tuinman, A. A., & Lorch, V. (1991). Release of benzalkonium chloride from a heparin-bonded umbilical catheter with resultant factitious hypernatremia and hyperkalemia. Pediatrics, 87(5), 631–635.

    CAS  Google Scholar 

  • Ji, J. Z., & Meng, Q. H. (2011). Evaluation of the interference of hemoglobin, bilirubin, and lipids on Roche Cobas 6000 assays. Clinica Chimica Acta, 412(17–18), 1550–1553.

    Article  CAS  Google Scholar 

  • Koch, T. R., & Cook, J. D. (1990). Benzalkonium interference with test methods for potassium and sodium. Clinical Chemistry, 36(5), 807–808.

    CAS  Google Scholar 

  • Ma, Z., Monk, T. G., Goodnough, L. T., McClellan, A., Gawryl, M., Clark, T., et al. (1997). Effect of hemoglobin- and Perflubron-based oxygen carriers on common clinical laboratory tests. Clinical Chemistry, 43(9), 1732–1737.

    CAS  Google Scholar 

  • National Institute of Health Children’s Study. http://www.nationalchildrensstudy.gov/Pages/default.aspx

  • Sassa, S. (2006). Modern diagnosis and management of the porphyrias. British Journal of Haematology, 135(3), 281–292.

    Article  CAS  Google Scholar 

  • Van Steirteghem, A. C., & Young, D. S. (1977). Povidone-iodine (“Betadine”) disinfectant as a source of error. Clinical Chemistry, 23(8), 1512.

    Google Scholar 

  • Wolthuis, A., Peek, D., Scholten, R., Moreira, P., Gawryl, M., Clark, T., et al. (1999). Effect of the hemoglobin-based oxygen carrier HBOC-201 on laboratory instrumentation: Cobas integra, chiron blood gas analyzer 840, Sysmex SE-9000 and BCT. Clinical Chemistry and Laboratory Medicine, 37(1), 71–76.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Christopher R. McCudden Ph.D. or Monte S. Willis M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer New York

About this chapter

Cite this chapter

McCudden, C.R., Willis, M.S. (2017). Post-analytical Issues in the Clinical Laboratory. In: Molinaro, R., McCudden, C., Bonhomme, M., Saenger, A. (eds) Clinical Core Laboratory Testing. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7794-6_5

Download citation

Publish with us

Policies and ethics