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    Designing and validating an autoverification system of biochemical test results in Hatay Mustafa Kemal University, clinical laboratory
    (Croatian Soc Medical Biochemistry & Laboratory Medicine, 2022) Gul, Bahar Unlu; Ozcan, Oguzhan; Dogan, Serdar; Arpaci, Abdullah
    Introduction: Autoverification (AV) is a postanalytical tool that uses algorithms to validate test results according to specified criteria. The Clinical and Laboratory Standard Institute (CLSI) document for AV of clinical laboratory test result (AUTO-10A) includes recommendations for laboratories needing guidance on implementation of AV algorithms. The aim was to design and validate the AV algorithm for biochemical tests. Materials and methods: Criteria were defined according to AUTO-10A. Three different approaches for algorithm were used as result limit checks, which are reference range, reference range +/- total allowable error, and 2nd and 98th percentile values. To validate the algorithm, 720 cases in middleware were tested. For actual cases, 3,188,095 results and 194,520 reports in laboratory information system (LIS) were evaluated using the AV system. Cohen's kappa (kappa) was calculated to determine the degree of agreement between seven independent reviewers and the AV system. Results: The AV passing rate was found between 77% and 85%. The highest rates of AV were in alanine transaminase (ALT), direct bilirubin (DBIL), and magnesium (Mg), which all had AV rates exceeding 85%. The most common reason for non-validated results was the result limit check (41%). A total of 328 reports evaluated by reviewers were compared to AV system. The statistical analysis resulted in a kappa value between 0.39 and 0.63 (P < 0.001) and an agreement rate between 79% and 88%. Conclusions: Our improved model can help laboratories design, build, and validate AV systems and be used as starting point for different test gro-ups.
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    Intra-day changes in the levels of biochemistry parameters
    (Kare Publishing, 2022) Arpaci, Abdullah; Dogan, Serdar; Gul, Bahar Unlu; Kus, Berna; Dirican, Emre
    Objectives: People mostly live in the nonfasting state during a normal 24-h cycle. This study aims to compare the levels of 18 biochemical parameters during different hours of the day. Methods: A total of 18 biochemical tests of patients who visited outpatient clinics only once between January 1, 2010, and December 31, 2019, were evaluated at the Hatay Mustafa Kemal University (HMKU) Central Laboratory by using hospital database information. The tests are albumin (Alb), aspartate aminotransaminase (AST), alanine aminotransam-inase (ALT), alkaline phosphatase (ALP), amylase, blood urea nitrogen (BUN), calcium (Ca), total cholesterol (TC), cre-atine kinase (CK), creatinine (Cr), gamma-glutamyltransferase (GGT), glucose, high-density lipoprotein cholesterol (HDL-C), inorganic phosphorus (Pi), iron (Fe), total protein (TP), triglyceride (TG), and lipase. The blood samples of the patient were divided into eight groups according to their collection time as follows: (a) 07:00-07:59, (b) 08:00-08:59, (c) 09:00-09:59, (d) 10:00-10:59, (e) 11:00-11:59, (f) 12:00-13:59, (g) 14:00-14:59, and (h) 15:00-17:00. Results: A statistically significant difference was found between the groups in terms of all parameters except amylase, GGT, and TP (p<0.05). The effect size refers to the minimum amount of difference that is clinically significant. According to the effect size values, there was no significant difference between time groups in the following parameters: Alb, ALT, AST, Pi, Ca, TC, Cr, Fe, glucose, BUN, lipase, TG, ALP, HDL-C, and CK (?<0.30). Conclusion: When considering all of the results, nonfasting screening would not only be acceptable but also make physiologic sense. © 2022, Kare Publishing. All rights reserved.
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    Presentation of two new mutations in the 3?untranslated region of the ?-globin gene and evaluating the molecular spectrum of thalassemia mutations in the Mediterranean region of Turkey
    (Springer, 2021) Arpaci, Abdullah; Gul, Bahar Unlu; Ozcan, Oguzhan; Ilhan, Gul; El, Cigdem; Dirican, Emre; Elmacioglu, Sibel
    Thalassemia is a common genetic disorder. We aimed to present thalassemia mutation data that covers a period of 7 years from the Mediterranean region of Turkey by comparing with hemoglobin indices and to contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly. In this study, in which a retrospective archive was scanned, the cases were first grouped as alpha and beta thalassemia, and then beta thalassemia mutations were examined in a total of 5 groups as UTR-Pro, Codon, IVS, beta(0), and beta(+). We have reached the family of the proband that analyzed their Hb indices and genetic mutation. All mutations were statistically compared with Hb indices, HbF, and HbA(2). We have identified two new beta thalassemia mutations that have the feature of not being defined previously [HBB:C*62 A>G. (3 ' UTR+1536 A>G) and HBB:C*1 G>A (3 ' UTR+1475 G>A)]. The most commonly encountered 23 mutations account for 74.7% of all mutations which is unlike the literature. In the beta thalassemia group, 73 different mutations were detected. The most common beta thalassemia mutation was HBB: c.93-21 G>A (IVS I-110 G>A) with a frequency of 19.72%. A statistically significant difference was found when comparing the mutation groups with Hb indices. We think that it may be useful to evaluate the mutations we have newly identified too together with the Hb indices especially in evaluating the carriers of thalassemia and it will contribute to prenatal diagnosis and genetic counseling studies which should be decided very quickly.