Medical Laboratory and Biomedical Science

Wednesday, October 23, 2013

Uncertainty in Diagnostic Semen Analysis

Uncertainty in relation to laboratory testing simply means the existence of doubt or level of error associated with a particular measurement. In general, if the evidence relating any given semen parameter with pregnancy outcome is weaker or controversial then it is likely that: either the study design was not particularly robust or the testing method used to measure that particular semen parameter is subject to a higher level of uncertainty.

From published evidence we are reasonably certain that the number, motility and morphology of sperm are important for a either natural or assisted conception. The conflicting evidence surrounding parameters such as DNA fragmentation or antisperm antibodies suggests that the testing procedures to measure these are subject to a higher level of ‘uncertainty’.

Evidence demonstrating Uncertainty associated with semen analysis

Changing clinical thresholds or reference ranges over the past 25 years (WHO, 1987, 1992, 1999, 2001).
A litany of publications questioning the clinical value of semen analysis.
Considerable variation in clinical practice in relation to treatment decision making based on sperm quality.
EQA data (UKNEQAS and American Association of Bioanalysts National Proficiency testing, Keel et al 2000).
Failure to establish consensus regarding the clinical significance or indeed the reference ranges for certain tests e.g. antisperm antibodies, DNA fragmentation (Barratt et al, 2010; Tomlinson et al, 2013).
Lack of automation in semen analysis in comparison to other areas of pathology.

Source: Embryo news
Image credits: Malpani Infertility Clinic

Art and Science of Laboratory Medicine

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Monday, October 21, 2013

Profiling Biomedical Laboratory Scientists

Amazing cartoon by Tan Hua Seng

Source: Facebook/ THSfb
Image credits: Tan Hua Seng

Art and Science of Laboratory Medicine

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Your Friendly Neighbourhood PCR Zombie

Laboratory related artwork by Aestling

Original posting
your friendly neighbourhood pcr zombie

Source: tumblr.
Image credits: Aestling

Art and Science of Laboratory Medicine

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New CLSI Method Evaluation Guideline - Reagent Lot Variation

The Clinical and Laboratory Standards Institute (CLSI) has published a new document, EP26-A—User Evaluation of Between-Reagent Lot Variation; Approved Guideline. In a laboratory setting, changes in measurement procedure performance may occur with a change in reagent lot. Therefore, it is a good laboratory practice to verify the consistency of patient sample results when introducing a new lot of reagents. This document provides guidance for laboratories on evaluation of a new reagent lot, including a protocol using patient samples to detect significant changes from the current lot.

EP26-A provides users with a protocol to evaluate the consistency of patient sample results when a new analytical reagent lot replaces a reagent lot currently in use. It also helps users detect significant changes in measurement procedure performance for patient samples due to reagent lot changes, and confirms that patient sample results are consistent between two reagent lots.

Read more:
CLSI Published a New Method Evaluation Guideline: EP26-A—User Evaluation of Between-Reagent Lot Variation

Source: CLSI
Image credits: MediaDiagnostici

Art and Science of Laboratory Medicine

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Human Papilloma Virus (HPV)

Vincent Racaniello speaks with Professor Harald zur Hausen, recipient of the 2013 Society for General Microbiology Prize Medal for "work that has had a far-reaching impact beyond microbiology."

Professor zur Hausen talks about the beginnings of his work on the human papilloma virus (HPV) starting in 1972 with a group he setup to look at the "isolation and characterization of the viruses in genital warts." This group would lead to the discovery of HPV 16 and 18 (the leading cause of cervical cancer) amongst many other types. The discovery of these two particular strains of HPV led to insights into the cancer causing properties of HPV which would result in the production of the HPV vaccine. Vincent and Professor zur Hausen also discuss other virus related cancers including the possibility that colon cancer is a product of a virus and the application of the HPV vaccine to males as well as females.

Watch video:
MWV Episode 80 - Harald zur Hausen - Human Papilloma Virus (HPV)