Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.

<h4>Background</h4>According to current recommendations, blood samples should be taken in the morning after 15 minutes' resting time. Some components exhibit diurnal variation and in response to pressures to expand opening hours and reduce waiting time, the aims of this study were t...

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Main Authors: Ida B Andersen, Claus L Brasen, Henry Christensen, Lene Noehr-Jensen, Dorthe E Nielsen, Ivan Brandslund, Jonna S Madsen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140475&type=printable
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author Ida B Andersen
Claus L Brasen
Henry Christensen
Lene Noehr-Jensen
Dorthe E Nielsen
Ivan Brandslund
Jonna S Madsen
author_facet Ida B Andersen
Claus L Brasen
Henry Christensen
Lene Noehr-Jensen
Dorthe E Nielsen
Ivan Brandslund
Jonna S Madsen
author_sort Ida B Andersen
collection DOAJ
description <h4>Background</h4>According to current recommendations, blood samples should be taken in the morning after 15 minutes' resting time. Some components exhibit diurnal variation and in response to pressures to expand opening hours and reduce waiting time, the aims of this study were to investigate the impact of resting time prior to blood sampling and diurnal variation on biochemical components, including albumin, thyrotropin (TSH), total calcium and sodium in plasma.<h4>Methods</h4>All patients referred to an outpatient clinic for blood sampling were included in the period Nov 2011 until June 2014 (opening hours: 7am-3pm). Each patient's arrival time and time of blood sampling were registered. The impact of resting time and the time of day for all components was analysed using simple linear regression. The "maximum allowable bias" was used as quality indicator for the change in reference interval.<h4>Results</h4>Significant diurnal variation was found for albumin (n = 15,544; p<2×10-16), TSH (n = 20,019; p<2×10-16), calcium (n = 13,588; p = 2.8×10-12) and sodium (n = 51,917; p<2×10-16). Further significant influence for resting time was found for albumin (p = 2.6×10-4), TSH (p = 0.004), calcium (p = 8.9×10-7) and sodium (p = 8.7×10-16). Only TSH and albumin were clinically significantly influenced by diurnal variation. Resting time had no clinically significant effect.<h4>Conclusions</h4>We found no need for resting 15 minutes prior to blood sampling. However, diurnal variation was found to have a significant and considerable impact on TSH and, to a minor degree, albumin. This has to be taken into account to ensure that reference intervals provided by the laboratory are valid on a 24-hour basis.
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spelling doaj-art-27df3e03cf93480997e847b3d858c0f02025-08-20T02:15:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-011010e014047510.1371/journal.pone.0140475Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.Ida B AndersenClaus L BrasenHenry ChristensenLene Noehr-JensenDorthe E NielsenIvan BrandslundJonna S Madsen<h4>Background</h4>According to current recommendations, blood samples should be taken in the morning after 15 minutes' resting time. Some components exhibit diurnal variation and in response to pressures to expand opening hours and reduce waiting time, the aims of this study were to investigate the impact of resting time prior to blood sampling and diurnal variation on biochemical components, including albumin, thyrotropin (TSH), total calcium and sodium in plasma.<h4>Methods</h4>All patients referred to an outpatient clinic for blood sampling were included in the period Nov 2011 until June 2014 (opening hours: 7am-3pm). Each patient's arrival time and time of blood sampling were registered. The impact of resting time and the time of day for all components was analysed using simple linear regression. The "maximum allowable bias" was used as quality indicator for the change in reference interval.<h4>Results</h4>Significant diurnal variation was found for albumin (n = 15,544; p<2×10-16), TSH (n = 20,019; p<2×10-16), calcium (n = 13,588; p = 2.8×10-12) and sodium (n = 51,917; p<2×10-16). Further significant influence for resting time was found for albumin (p = 2.6×10-4), TSH (p = 0.004), calcium (p = 8.9×10-7) and sodium (p = 8.7×10-16). Only TSH and albumin were clinically significantly influenced by diurnal variation. Resting time had no clinically significant effect.<h4>Conclusions</h4>We found no need for resting 15 minutes prior to blood sampling. However, diurnal variation was found to have a significant and considerable impact on TSH and, to a minor degree, albumin. This has to be taken into account to ensure that reference intervals provided by the laboratory are valid on a 24-hour basis.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140475&type=printable
spellingShingle Ida B Andersen
Claus L Brasen
Henry Christensen
Lene Noehr-Jensen
Dorthe E Nielsen
Ivan Brandslund
Jonna S Madsen
Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
PLoS ONE
title Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
title_full Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
title_fullStr Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
title_full_unstemmed Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
title_short Standardised Resting Time Prior to Blood Sampling and Diurnal Variation Associated with Risk of Patient Misclassification: Results from Selected Biochemical Components.
title_sort standardised resting time prior to blood sampling and diurnal variation associated with risk of patient misclassification results from selected biochemical components
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140475&type=printable
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