Quality assurance and sample handling in cerebrospinal fluid investigation

  • S. Öhman
Conference paper


Clinical chemistry begins and ends with two decisions: a) to take a sample and b) to act according to the result of the analysis. In between a series of events take place; each step involves a certain risk of making mistakes. The art of avoiding such mistakes is called Quality Assurance (QA).


Multiple Sclerosis Multiple Sclerosis Patient Good Laboratory Practice Quality Assurance System Artefactual Band 
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  1. 1.
    Poser CM, Paty DW, Scheinberg L, McDonald I, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Ann Neurol 13: 227–231PubMedCrossRefGoogle Scholar
  2. 2.
    Andersson M, Alvarez-Cermeño J, Bernardi G, Cogato I, Fredman P, Fredriksen J, Fredriksson S, Gallo P, Grimaldi LM, Gr0nning M, Keir G, Lamers K, Link H, Magalhães A, Massaro AR, Öhman S, Reiber H, Rönnbäck L, Schluep M, Schuller E, Sindic CJM, Thompson EJ, Trojano M, Wuster U (1994) The role of cerebrospinal fluid analysis in the diagnosis of multiple sclerosis: A consensus report. J Neurol Neurosurg Psychiatr 57:897–902PubMedCrossRefGoogle Scholar
  3. 3.
    Mehta PD (1991) Diagnostic usefulness of cerebrospinal fluid in multiple sclerosis. Crit Rev Clin Lab Sci 28: 223–251CrossRefGoogle Scholar
  4. 4.
    Link H (1991) The cerebrospinal fluid in multiple sclerosis. In: Swash M, Oxbury J (eds) Clinical Neurology. Vol 2, Churchill Livingstone, Edinburgh, pp 1128–1139Google Scholar
  5. 5.
    Öhman S, Ernerudh J, Forsberg P, Roberg M, Vrethem M (1995) Lower values for immunoglobulin M in cerebrospinal fluid when sampled with an atraumatic Sprotte needle compared with conventional lumbar puncture. Ann Clin Biochem 32: 210–212PubMedGoogle Scholar
  6. 6.
    Thompson EJ, Keir G (1990) Laboratory investigation of cerebrospinal fluid proteins. Ann Clin Biochem 27: 425–435PubMedGoogle Scholar
  7. 7.
    Blennow K, Fredman P, Wallin A, Gottfries CG, Långström G, Svennerholm L (1993) Protein analyses in cerebrospinal fluid. Eur Neurol 33:126–128PubMedCrossRefGoogle Scholar
  8. 8.
    Watson MA, Scott MG (1995) Clinical utility of biochemical analysis of cerebrospinal fluid. Clin Chem 41: 343–360PubMedGoogle Scholar
  9. 9.
    Fieschi C, Gasperini C, Ristori G, Bastianello S, Girmenia F, Leuzzi V (1995) Patients with clinically definite multiple sclerosis, white matter abnormalities on MRI, and normal CSF: if not multiple sclerosis, what is it? J Neurol Neurosurg Psych 58: 255–256CrossRefGoogle Scholar
  10. 10.
    Eilers RJ (1975) Quality assurance in health care: missions, goal, activities. Clin Chem 21: 1357–1367PubMedGoogle Scholar
  11. 11.
    Williams GW, Schork MA (1982) Basic statistics for quality control in the clinical laboratory. CRC Crit Rev Clin Lab Sci 17:171–199CrossRefGoogle Scholar
  12. 12.
    Reiber H (1995) External quality assessment in clinical neurochemistry: Survey of analysis for cerebrospinal fluid (CSF) proteins based on CSF/serum quotients. Clin Chem 41:256–263PubMedGoogle Scholar
  13. 13.
    Olsson T, Kostulas V, Link H (1984) Improved detection of oligoclonal IgG in cerebrospinal fluid by isoelectric focusing in agarose, doubleantibody peroxidase labelling, and avidin-biotin amplification. Clin Chem 30:1246–1249PubMedGoogle Scholar
  14. 14.
    Keir G, Luxton RW, Thompson EJ (1990) Isoelectric focusing of cerebrospinal fluid immunoglobulin G: an annotated update. Ann Clin Biochem 27: 436–443PubMedGoogle Scholar
  15. 15.
    Büttner J (ed) (1995) Proceedings of the IFCC meeting on reference materials and reference systems co-sponsored by WHO. Geneva, October 5–7 1994. Eur J Clin Chem Clin Biochem 33: 975–1022Google Scholar
  16. 16.
    Uldall A (1987) Quality assurance within clinical chemistry — a brief review emphasizing “good laboratory practice”. Scand J Clin Lab Invest 47: 507–518Google Scholar
  17. 17.
    Miller JC, Miller JN (1989) Statistics for analytical chemistry. 2nd edn, Ellis Horwood Ltd, ChichesterGoogle Scholar
  18. 18.
    Lefvert AK, Link H (1985) IgG production within the central nervous system: A critical review of proposed formulae. Ann Neurol 17:13–20PubMedCrossRefGoogle Scholar
  19. 19.
    Tibbling G, Link H, Öhman S (1977) Principles of albumin and IgG analyses in neurological disorders. L Establishment of reference values. Scand J Clin Lab Invest 37: 385–390PubMedCrossRefGoogle Scholar
  20. 20.
    McLean BN, Luxton RW, Thompson EJ (1990) A study of immunoglobulin G in the cerebrospinal fluid of 1007 patients with suspected neurological disease using isoelectric focusing and the log IgG-index. Brain 113:1269–1289PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • S. Öhman
    • 1
  1. 1.Department of Clinical Chemistry, Faculty of Health SciencesUniversity of LinköpingLinköpingSweden

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