Accurate Results in the Clinical Laboratory

Accurate Results in the Clinical Laboratory, 1st Edition

A Guide to Error Detection and Correction

Accurate Results in the Clinical Laboratory, 1st Edition,Amitava Dasgupta,Jorge Sepulveda,ISBN9780124157835

Dasgupta   &   Sepulveda   





276 X 216

Practical, easy-to-use guide to interference issues across all types of clinical laboratory tests- for both clinicians and clinical laboratory scientists.

Print Book + eBook

USD 119.94
USD 199.90

Buy both together and save 40%

Print Book


In Stock

Estimated Delivery Time
USD 99.95

eBook Overview

VST (VitalSource Bookshelf) format

DRM-free included formats : EPUB, Mobi (for Kindle), PDF

USD 99.95
Add to Cart

Key Features

  • Named to Doody’s Core Titles 2013, a collection development tool for health sciences libraries of all sizes, by Doody Enterprises
  • Practical information for both clinicians and laboratory scientists, presented in the form of tables and charts for easy reference
  • Focus on range and sources of interferences rather than details of toxicologic mechanisms which are well covered in toxicology textbooks
  • Covers interferences across endocrine, oncology, hematology, immunohistochemistry, immunology, serology, microbiology, and molecular testing


This practical, easy-to-use guide, named to Doody’s Core Titles 2013, addresses interference issues in all laboratory tests, including patient epigenetics, process of specimen collection, enzymes, biomarkers. Clinicians and laboratory scientists can therefore rely on one reference which speaks to both their needs of accurate specimen analysis and optimal patient care.

Erroneous hospital and pathology laboratory results can be confusing and problematic, especially in acute care situations. While some factors creating interference, can be identified in the laboratory, detecting many others is often dependent on clinical details unavailable to the laboratory scientists or pathologists. Therefore, clinicians must become proficient in identifying such erroneous reports, and working with pathologists and laboratory scientists so that they can understand the source of such interferences, correct the results, and then decide what course of action must be followed for proper patient management.


Pathologists, clinical chemists, and toxicologists; practicing clinicians, fellows and residents in pathology, internal medicine, emergency medicine and family practice.

Amitava Dasgupta

Amitava Dasgupta received his PhD degree in Chemistry from Stanford University and his fellowship training in Clinical Chemistry from the Laboratory Medicine Department of the University of Washington School of Medicine at Seattle. He is a tenured Full Professor of Pathology and Laboratory Medicine at the University of Texas Health Sciences Center located at the Texas Medical Center at Houston. Dr. Dasgupta has published 210 scientific papers, written many invited review articles, and has edited, co-edited or written 15 books. He is on the Editorial Board of five major medical journals including American Journal of Clinical Pathology, Archives of Pathology and Laboratory Medicine, Therapeutic Drug Monitoring, Clinica Chimica Acta and Journal of Clinical Laboratory Analysis.

Affiliations and Expertise

Professor, Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA

View additional works by Amitava Dasgupta

Jorge Sepulveda


Jorge Sepulveda received his M.D. from the University of Lisbon, Portugal, and his residency training in Laboratory Medicine and Ph.D. degree in Cell and Molecular Biology from Baylor College of Medicine, Houston, Texas. He is board certified by the American Board of Pathology in Clinical Pathology and Transfusion Medicine. He has published over 35 research articles, review papers and book chapters, and serves as Associate Editor for the Archives of Pathology and Laboratory Medicine. Dr. Sepulveda has broad experience in laboratory medicine as medical director of various clinical laboratories, including at the Houston and Philadelphia Veterans Affairs Medical Centers and at the University of Pittsburgh Presbyterian and Shadyside Hospitals, and currently serves as Associate Medical Director of the Clinical Laboratories at the Columbia University Medical Center Campus of New York-Presbyterian Hospital.

Affiliations and Expertise

Associate Professor and Associate Director of Laboratory Medicine, Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA

Accurate Results in the Clinical Laboratory, 1st Edition



List of Contributors

Chapter 1. Variation, Errors, and Quality in the Clinical Laboratory


Errors in the Clinical Laboratory

Quality Improvement in the Clinical Laboratory



Chapter 2. Effect of Age, Gender, Diet, Exercise, and Ethnicity on Laboratory Test Results


Effects of Age-Related Changes on Clinical Laboratory Test Results

Effects of Gender-Related Changes on Clinical Laboratory Test Results

Effects of Diet on Clinical Laboratory Test Results

Effects of Nutraceuticals on Clinical Laboratory Test Results

Effects of Exercise on Clinical Laboratory Test Results

Effects of Ethnicity/Race on ClinicaL Laboratory Test Results



Chapter 3. Effect of Patient Preparation, Specimen Collection, Anticoagulants, and Preservatives on Laboratory Test Results


Biological Rhythms and Laboratory Test Results

Issues of Patient Preparation

Differences Between Whole Blood, Plasma, and Serum Specimens for Clinical Laboratory Analysis

Different Anticoagulants and Preservatives, Order of Draw, Problems with Gel Interference in Serum Separator Tubes, and Short Draws

Order of Draw of Various Blood Collection Tubes

Collection Sites; Differences Between Arterial, Capillary, and Venous Blood Samples; and Problems with Collections from Catheters and Intravenous Lines

Urine Collection, Timing, and Techniques



Chapter 4. Sample Processing and Specimen Misidentification Issues



The Effects of Centrifugation on Laboratory Results

Effect of Storage Conditions on Laboratory Results

Effect of Cross-Contamination of Specimens on Laboratory Results

Consequences of Specimen Misidentification on Laboratory Testing



Chapter 5. Hemolysis, Lipemia, and High Bilirubin: Effect on Laboratory Tests


Effect of Hemolysis on Laboratory Tests



Methods for Evaluating the Effect of Endogenous Interfering Substances on Laboratory Tests



Chapter 6. Immunoassay Design and Mechanisms of Interferences


Immunoassay Methods and Assay Principles

Specimen Types Used in Immunoassays

Examples of Immunoassays

Pitfalls in Immunoassays

How to Detect and Correct Heterophilic Antibody Interferences



Chapter 7. Effect of Herbal Remedies on Clinical Laboratory Tests


Elevated Liver Function Test Due to Use of Herbal Supplements

Herbal Supplements Causing Kidney Damage

Herbal Remedies and Hypoglycemia

Licorice and Hypokalemia

Kelp and Abnormal Thyroid Function Tests

Drug–Herb Interaction and Unexpected Drug Levels in Routine Drug Monitoring

Adulteration of Herbal Supplements with Western Drugs



Chapter 8. Challenges in Routine Clinical Chemistry Testing: Analysis of Small Molecules


Creatinine Analysis

Urea Analysis

Ammonia Assay

Uric Acid Analysis

Glucose Analysis

Analysis of Electrolytes

Blood Gases Analysis

Lactate Analysis

Bilirubin Analysis

Lipid Profiles Analysis



Chapter 9. Challenges in Routine Clinical Chemistry Analysis: Proteins and Enzymes


Albumin and Total Protein

Alanine and Aspartate Aminotransferases Analysis

γ-Glutamyl Transferase and Alkaline Phosphatase Analysis

Amylase and Lipase Analysis

Lactate Dehydrogenase Analysis

Creatine Kinase Analysis

Cardiac Troponin Analysis

B-Type Natriuretic Peptide Analysis



Chapter 10. Sources of Inaccuracy in Biochemical Genetics Testing


Analysis of Amino ACIDS

Analysis of Organic ACIDS

Analysis of Acylcarnitines



Chapter 11. Challenges in Endocrinology Testing


Challenges in Testing of Hormones Secreted by Pituitary

Challenges in Measuring Human Chorionic Gonadotropin

Challenges in Thyroid Tumor Marker Tests

Adrenal Function Tests

Testing of Parathyroid Function

Gonadal and Reproductive Interferences


Testing for Insulin-Like Growth Factor 1

Measurement of Other Hormones Including Insulin

Prenatal Testing



Chapter 12. Pitfalls in Tumor Markers Testing


Clinical Uses of Tumor Markers

Prostate-Specific Antigen


α-Fetal Protein

Carcinoembryonic Antigen



Human Chorionic Gonadotropin

Interference from Heterophilic Antibodies in Laboratory Testing of Tumor Markers

Analysis of Less Frequently Assayed Tumor Markers



Chapter 13. Issues of Interferences in Therapeutic Drug Monitoring


Sources of Pre-Analytical Interferences in TDM

Sources of Analytical Interferences in TDM

Mechanisms of Analytical Interferences in TDM

Chromatography and Mass Spectrometry

Examples of Interferences that Affect TDM



Chapter 14. Limitations of Drugs of Abuse Testing


Drugs of Abuse Testing: Medical Versus Legal

Drugs Tested in Drugs of Abuse Testing Protocols

Drug Testing Methodologies

Challenges in Testing for Amphetamines

Challenges in Testing of Cocaine Metabolite

Challenges in Testing for Opiates

Challenges in Testing for Marijuana Metabolites

Challenges in Testing for Phencyclidine

Challenges in Testing for Benzodiazepines

Challenges in Determining Other Drugs by Immunoassays

Adulterants and Drugs of Abuse Testing

Other Drugs not Detected by Routine Toxicology Screens



Chapter 15. Challenges in Confirmation Testing for Drugs of Abuse

Introduction: Factors to Consider when Interpreting Drug Testing Results

Confirmation Testing Process

Confirmation of Amphetamines

Confirmation of Cocaine Metabolite Benzoylecgonine

Confirmation of Opiates

Confirmation of Marijuana Metabolite

Confirmation of Phencyclidine

Confirmation of Benzodiazepines

Confirmation of Barbiturates

Specimen Validity Testing



Chapter 16. Alcohol Determination Using Automated Analyzers: Limitations and Pitfalls


Development of Laboratory Methods for Ethanol Measurement

Current Automated Methodologies

Performance of Automated Ethanol Assays

Problems with Current Methodologies

Strategies for Removing Interferences

Further Case Studies

Future Directions



Chapter 17. Pre-Analytical Issues and Interferences in Transfusion Medicine Tests


Basics of Immunohematology

Methodology Used for Immunohematology Tests

Pre-Transfusion Evaluation

Interferences in Basic Transfusion Medicine Tests

Case Studies



Chapter 18. Issues with Immunology and Serology Testing


Challenges in Hemoglobinopathy Detection

Detection of Monoclonal Proteins

Challenges in HIV Testing

Hepatitis Testing

Anti-Nuclear Antibodies



Chapter 19. Sources of Errors in Hematology and Coagulation Testing


Errors in Hemoglobin Measurement and RBC Count

Errors in MCV and Related Measurements

Errors in WBC Counts and WBC Differential Counts

Errors in Platelet Count

Errors in Specific Hematology Testing

Coagulation Testing

Errors in PT and aPTT Measurements

Errors in Thrombin Time Measurement

Platelet Aggregation Testing with Lipemic, Hemolyzed, or Thrombocytopenic Samples

Challenges in Anticoagulants and Lupus Anticoagulant Tests

Case Studies



Chapter 20. Challenges in Clinical Microbiology Testing


Issues with Pre-Analytical Errors

Analytical Errors in the Microbiology Laboratory

Post-Analytical or Reporting Errors

Error Prevention, Detection, and Monitoring



Chapter 21. Sources of Errors in Molecular Testing


Principles of Commonly Used Methods for Molecular Diagnostics

Principles of Nucleic Acid Isolation

Pre-Analytical Considerations in Molecular Testing

Interferences in Molecular Diagnostics: False-Negative Results in Molecular Assays

Interferences in Molecular Testing: False-Positive Test Results in Molecular Assays

Sources of Errors in DNA Microarray Testing

Quality Management



Chapter 22. Problems in Pharmacogenomics Testing


Method Descriptions

Applications of Pharmacogenetics Testings

Case Studies




Quotes and reviews

"Dasgupta and Sepulveda offer clinicians and laboratory scientists a guide to error detection and correction in the clinical laboratory that addresses sources of errors in analytical methods and sources of pre-analytical variation."--Reference and Research Book News, August 2013
"This is a very helpful book correlating nonanalytical measurement errors or disease states with anticipated effects on laboratory test results. This would be a must for the laboratory medicine resident who has to explain why results don't correlate with clinical disease."--Doody.com, August 9, 2013

Free Shipping
Shop with Confidence

Free Shipping around the world
▪ Broad range of products
▪ 30 days return policy

Contact Us