A5058859746- Forensic Toxicology and Drug Analysis
- Clinical Laboratory Practices and Quality Control
- Opioid Use Disorder Treatment
- Poisoning and overdose treatments
- Pain Management and Opioid Use
- SARS-CoV-2 detection and testing
- Meta-analysis and systematic reviews
- Acute Myocardial Infarction Research
- SARS-CoV-2 and COVID-19 Research
- Electronic Health Records Systems
- COVID-19 Clinical Research Studies
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Bacterial Identification and Susceptibility Testing
- Biomedical and Engineering Education
- Pharmacogenetics and Drug Metabolism
- Healthcare cost, quality, practices
- Pharmaceutical Practices and Patient Outcomes
- Veterinary Pharmacology and Anesthesia
- Hormonal and reproductive studies
- Metabolomics and Mass Spectrometry Studies
- Prenatal Substance Exposure Effects
- Health Sciences Research and Education
- Antimicrobial Resistance in Staphylococcus
- Treatment of Major Depression
- Biosensors and Analytical Detection
Harvard University
2016-2025
Brigham and Women's Hospital
2016-2025
Mass General Brigham
2024-2025
University of Iowa Hospitals and Clinics
2019
ARUP Laboratories (United States)
2019
Tufts University
2011-2019
Tufts Medical Center
2019
College of American Pathologists
2019
Mayo Clinic in Arizona
2019
Lemuel Shattuck Hospital
2019
Cardiac troponins are important biochemical markers for defining the presence of myocardial injury. However, limitations in troponin testing exist, including relatively late increase after onset ischemia. We therefore evaluated a more sensitive assay detection injury "early presenters." Discarded serial specimens were obtained from 103 patients who had negative cardiac I (cTnI) result followed by positive cTnI result. Results using our current method and new assay, TnI-Ultra (Siemens Medical...
In the United States, minimum standards for quality control (QC) are specified in federal law under Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program.We surveyed chemistry immunochemistry procedures at 21 clinical within leading academic medical centers assess if standardized practices exist testing.We observed significant variation unexpected similarities practice across...
M any clinical chemistry laborato- ries perform troponin testing to aid in the diagnosis of acute coronary syndrome (ACS).Laboratories must interact with clinicians establish diagnostic cut points, achieve acceptable assay performance, and troubleshoot questionable findings.Here we present 3 hypothetical scenarios related laboratory. Troponin: Its Utility Acute Coronary SyndromeCase Presentation 1: J.P. is an obese 55-year-old male a history gastroesophageal reflux disease who presents...
Vancomycin trough levels are recommended to predict vancomycin efficacy, and inaccurate may lead inappropriate clinical actions. However, the frequency of timing errors associated impact is unknown. We retrospectively analyzed (n = 2,597) measured during 13 months at a large academic medical center. Of specimens, 41.3% were drawn too early. These samples yielded significantly higher average ± SD concentrations than correctly timed (22.1 11.7 mg/L vs 15.5 8.6 mg/L; P < .001), and,...
To review cases and increase awareness in clinicians treating patients who may be taking biotin.We describe the presentation workup of a woman with secondary progressive multiple sclerosis on high dose biotin laboratory studies suggestive thyrotoxicosis.Plasma samples showed evidence elevated thyroid hormone levels free thyroxine >7.8 ng/dl (reference interval (RI) 0.9-1.7 ng/dl) decreased stimulating <0.02 uIU/ml (RI 0.50-5.70 uIU/ml). Laboratory values normalized when was withheld prior to...
BACKGROUND Wrong blood in tube (WBIT) errors are a preventable cause of ABO‐mismatched RBC transfusions. Electronic patient identification systems (e.g., scanning patient's wristband barcode before pretransfusion sample collection) thought to reduce WBIT errors, but the effectiveness these is unclear. STUDY DESIGN AND METHODS Part 1: Using retrospective data, we compared rates at hospitals using manual (n = 16 sites; >1.6 million samples) with electronic for some or all collections 4...
Ensuring accurate patient identification is central to preventing medical errors, but it can be challenging. We implemented a bar code-based positive system for use in inpatient phlebotomy. A before-after design was used evaluate the impact of on frequency mislabeled and unlabeled samples reported our laboratory. Labeling errors fell from 5.45 10,000 before implementation 3.2 afterward (P = .0013). An estimated 108 mislabeling events were prevented by 1 year. Furthermore, workflow step...
Our goals were to improve the overall patient experience and optimize blood collection process in outpatient phlebotomy using Lean principles. Elimination of non-value-added steps modifications operational processes resulted increased capacity handle workload during peak times without adding staff. The result was a reduction average wait time from 21 5 minutes, with goal drawing samples within 10 minutes arrival at station met for 90% patients. In addition, satisfaction noticeably as...
The AACC Academy, formerly the National Academy of Clinical Biochemistry, has developed a laboratory medicine practice guideline (LMPG)10 for using tests to monitor drug therapy in pain management patients. purpose this was compile evidence-based recommendations use and point-of-care (POC) urine relevant over-the-counter medications, prescribed nonprescribed drugs, illicit substances exact process preparing publishing LMPG is shown Table 1. View table: Table 1. Process...
Patients treated for chronic pain may frequently undergo urine drug testing to monitor medication compliance and detect undisclosed prescribed or illicit use. Due the increasing use abuse of benzodiazepines, this class medications is often included in screening panels. However, immunoassay-based methods lack requisite sensitivity detecting benzodiazepine population primarily due their poor cross-reactivity with several major urinary metabolites. A High Sensitivity Cloned Enzyme Donor...
Abstract Context.—Laboratory automation proposes to improve the quality and efficiency of laboratory operations, may provide a solution demands staff shortages faced by today's clinical laboratories. Several vendors offer systems in United States, with both subtle obvious differences. Arriving at decision automate, ensuing evaluation available products, can be time-consuming challenging. Although considerable discussion concerning automate has been published, relatively little attention paid...
Urine buprenorphine screening is utilized to assess compliance and detect illicit use. Robust assays should be specific for without cross-reactivity with other opioids, which are frequently present in patients treated opioid addiction chronic pain. We evaluated the new Lin-Zhi urine enzyme immunoassay (EIA) as a potentially more alternative Microgenics cloned donor (CEDIA) by using 149 urines originating from pain addiction. The EIA methodology offered detection of use (100%) (106/106)...
It can be challenging to successfully monitor medication compliance in pain management. Clinicians and laboratorians need collaborate optimize patient care maximize operational efficiency. The test menu, assay cutoffs, testing algorithms utilized the urine drug panels should periodically reviewed tailored population effectively assess avoid unnecessary cost patient. Pain management pathology collaborated on an important quality improvement initiative for monitoring We retrospectively 18...
- A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR laboratory information system (LIS).- To determine the impact interfaced EHR-LIS on processes.- We analyzed several different processes before after EHR-LIS: turnaround time, number stat specimens received, venipunctures per patient day, preanalytic errors in phlebotomy, add-on...
The COVID-19 pandemic has made a devastating impact on global health and continues to challenge healthcare infrastructure delivery. clinical laboratories were no exception as they are responsible for diagnostic testing that dictates many clinical, infection control, public decisions. Information technology laboratory management tools critical assets maintaining adapting operations in response crises. When utilized effectively, promote the integration between specialties (e.g., chemistry,...
We describe the patterns of utilization arterial blood gas (ABG) tests in a large tertiary care hospital. To our knowledge, no hospital-wide analysis ABG test has been published. analyzed 491 performed during 24 two-hour intervals, representative different staff shifts throughout 7-day week. The clinician ordering each was asked to fill out survey. most common reasons for requesting an were changes ventilator settings (27.6%), respiratory events (26.4%), and routine (25.7%). Of results,...