Surrogate biomarkers for monitoring healthcare quality for chronic diseases such as diabetes care

Some laboratory tests or biomarkers are used as surrogate outcomes for health care effectiveness. HbA1c is defined as a surrogate biomarker since HbA1c values have been approved to be used in predictions of clinically important complications of diabetes mellitus. With the advance of information technology (IT) the real life data are aggregating as electronic health records (EHRs). About 70-85% of individuals admitted to hospitals have laboratory test results. As such, medical laboratories are the data centers in the hospitals. The test results can be used for assessment of health care delivered, especially for chronic diseases. This information provides insights of healthcare services, and can be used to enhance for individual and population well-being, research, and education. This article focuses on the importance of using laboratory tests results as outcome measures for specific population health status that are important in assessing the quality of health care services. The findings from our studies on the diabetic care quality is presented. © 2018 International Federation of Clinical Chemistry and Laboratory Medicine. All rights reserved

Lipid Peroxidation In Patients With Multipl Myeloma

Multipl myelomlu hastalarda lipid peroksidasyonunun aktivitesini belirlemek için ön çalışma olarak serum malondialdehit (MDA) düzeyinin ölçülmesi esasına dayanmaktadır. On iki multipl myelomlu hasta ve onbeş sağlıklı kontrol gurubunda açlık venöz kan örneklerinden elde edilen serum örnekleri analiz edilene dek -20 C° de donduruldu.Tümörnekler oda sıcaklığında ısıtıldı. MDA'nın asidik ortamda tiyobarbutirik asitle oluşturduğu renk şiddeti 532 nm dalga boyunda spektrofotometrede okunması ile yapıldı. Multipl myelomlu hastalarda serumMDAdüzeyleri ortalama 1.51 0.16 nmol/ml, kontrol gurubunda ise 0.97 0.11nmol/ml (p:0.0321) olarak bulundu. MDA düzeyi ile yaş, cins, paraprotein ve hafif zincir tipi, hemoglobin düzeyi arasında ilişki yoktu (p>0.05). Serum MDAdüzeyi multipl myelomlu hastalarda kontrol gurubuna göre yüksek saptandı (p<0.05). Elde edilen sonuçlar ön değerlendirme niteliğinde olup multipl myelomlu hastalarda artmış oksidatif stresi işaret etmektedir.We investigated the malondialdehyde (MDA) levels as a parameter of lipid peroxidation in patients with multiple myeloma as a preliminary report. Fasting venous blood samples were drawn in 12 patients with multiple myeloma and 15 healthy persons. Serum was separated and frozen at -20 C°. All samples were thawed at room temperature and MDA levels were measured by the method in which MDA reacted with thiobarbituric acid and produced a colored complex. This colored complex was read by optic scale at 532 wavelength . MDAlevels were 1.51 0.16 nmol/ml in patients with multiple myeloma and 0.97 0.11 nmol/ml in the control group (P<0.05). We didn't observe a significant relationship between the concentration of MDA and age, sex, paraprotein level, light chain type and hemoglobin levels (p>0.05). Plasma MDA levels were found to be higher in multiple myeloma in comparison to control group (p<0.05). These results are a preliminary report and the higher plasma MDA levels could be an indicator of increased oxidative stress in multiple myeloma

Yükseköğretim kurumunda iç paydaş memnuniyet analizi: Pamukkale Üniversitesi örneği

Quality development studies in higher education institutions become more of an issue in recent years regarding competition globally. The studies in the universities in Turkey are carried out within the scope of the legislation determined by the Council of Higher Education. In this context, universities are held responsible of setting up the internal quality assurance system and external quality assurance system and as well as internal and external evaluation processes. In this study, the internal shareholders (academic staff, administrative staff, and students) satisfaction surveys conducted in the context of the internal evaluation process in a higher education institution and designed according to the Guidelines for Preparing the Institutional Internal Evaluation Report of the Higher Education Council were analyzed using Structural Equation Model. Factors affecting the satisfaction of the shareholders were determined according to the obtained data, and it was determined that the survey was not appropriate for the questioning of the students even though the same and high relation was observed between the subheadings in the questionnaire prepared for the students

Use of total patient data for indirect estimation of reference intervals for 40 clinical chemical analytes in Turkey

In the present study we used patient data to calculate laboratory-specific indirect reference intervals. These values were compared with reference intervals obtained for a healthy group according to recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine and manufacturer suggestions. Laboratory results ( 422,919 records) from all subjects of 18-45 years of age over a 1-year period were retrieved from our laboratory information system and indirect reference intervals for 40 common analytes were estimated using a modified Bhattacharya procedure. Indirect reference intervals for most of the biochemical analytes were comparable, with small differences in lower [alkaline phosphatase (ALP) ( male), alanine aminotransferase ( ALT), creatine kinase, iron ( male), total iron-binding capacity, folic acid, calcium ( female), lactate dehydrogenase (LDH), lipoprotein ( a) [Lp(a)], thyroid-stimulating hormone (TSH), total triiodothyronine ( T-3), direct bilirubin, apolipoprotein A-I ( apoA-I), glucose, homocysteine, total cholesterol, ferritin, total protein, ceruloplasmin, sodium, blood urea nitrogen (BUN) and uric acid ( female)] and/or upper limits [albumin, ALP ( male), amylase, apoA-I, creatine kinase-MB (CK-MB), total iron-binding capacity, phosphorus, glucose, total cholesterol, g-glutamyltransferase (g-GT), magnesium, total protein, high-density lipoprotein cholesterol (HDL-C), total T-3, ALP ( male), ALT, aspartate aminotransferase (AST) ( male), direct bilirubin ( male), creatine kinase, iron, folic acid ( female), Lp( a), uric acid and triglycerides], to the reference intervals determined for healthy subjects in our laboratory. The indirect reference intervals, with the exception of a few parameters ( creatinine, direct total bilirubin, calcium, BUN and potassium), were not similar to the reference intervals suggested by the manufacturers. We conclude that laboratory-specific reference intervals can be determined from stored data with a relatively easy and inexpensive method. Indirect reference intervals derived from stored data may be particularly suitable for the evaluation of results for the presenting population

Which skills are needed and how they should be gained by laboratory medicine professionals for successful ISO 15189 accreditation

Clinical laboratories worldwide are accredited according to the “ISO standard, 15189:2012: Medical Laboratories—Requirements for Quality and Competence.” Seeking accreditation has many challenges. Success requires the right competencies and knowledge and the right technical expert and trainer to lead the laboratory through the process. The right competencies and knowledge typcially are beyond the core knowledge, skills and attitudes gained during education of laboratory professionals. The main objective of this paper is to discuss what competencies, knowledge and expertise are essential for laboratories to meet accreditation challenges and gain ISO 15189:2012 accreditation. © 2018 International Federation of Clinical Chemistry and Laboratory Medicine. All rights reserved