Clinical laboratory automation

Columbus RE, Palmer HJ. The integrated blood-collection system as a vehicle into complete clinical laboratory automation, Clin Chem 1991 37 1548-58. 

The NCCLS has developed standards to meet the requirements of vendors and users of clinical laboratory automation systems. Five standards have now been published at the approved level dealing with specimen container and specimen carrier bar codes for specimen container identification communications with automated clinical laboratory systems, instruments, devices, and information systems b systems operational requirements, characteristics,... 

Marlon RS. Recent trends in clinical laboratory automation. Clin Lab Manage Rev 1998 12 176-80. 

Automation in the Clinical Laboratory Automation in the Clinical Laboratory Appendix Selection and Analytical Evaluation of Methods—With Statistical Techniques Selection and Analytical Evaluation of Methods—With Statistical Techniques Appendix... 

Automation in the Clinical Laboratory Automation in the Clinical Laboratory Appendix... 

In some laboratories, e.g., clinical laboratories, automation and encapsulation have greatly reduced chemical exposure of the workers. In some other types of laboratories, e.g., research institutions or industrial laboratories, manual handling of hazardous materials is still a problem. In the future, automation and encapsulation may further reduce chemical exposure during routine analysis, but new types of biological and chemical hazards may nevertheless arise from the use of recombinants in genetic and molecular biological laboratory work (Norback 1997 Estlander et al. 1998). 

Arakawa M, and Kohno H, Japanese Journal of Clinical Laboratory Automation (in Japanese), 33,14-20 (2008). 

Chemical kinetic methods of analysis continue to find use for the analysis of a variety of analytes, most notably in clinical laboratories, where automated methods aid in handling a large volume of samples. In this section several general quantitative applications are considered. 

EIAs can be used per se or with a spectrophotometer. Traditionally, EIAs have been developed in 96-weU microtiter plates which provide the immobilization support for the assay, the reaction vessel, and, when linked to a spectrophotometer-based reader, a rapid means to detect and quantify the color resulting from interaction of a substrate with the antibody—antigen—enzyme complex. Automated immunoassay analyzers targeted primarily for use in the clinical laboratory have taken automation one step further, utilizing robotics to carry out all reagent additions, washings, and final quantification including report preparation. 

Immunosensors promise to become principal players ia chemical, diagnostic, and environmental analyses by the latter 1990s. Given the practical limits of immunosensors (low ppb or ng/mL to mid-pptr or pg/mL) and their portabiUty, the primary appHcation is expected to be as rapid screening devices ia noncentralized clinical laboratories, ia iatensive care faciUties, and as bedside monitors, ia physicians offices, and ia environmental and iadustrial settings (49—52). Industrial appHcations for immunosensors will also include use as the basis for automated on-line or flow-injection analysis systems to analyze and control pharmaceutical, food, and chemical processing lines (53). Immunosensors are not expected to replace laboratory-based immunoassays, but to open up new appHcations for immunoassay-based technology. 

Numerous workers have found that measurements of serum lipase activity are useful in the diagnosis of pancreatitis (83, 84, 85). Despite this, serum lipase determinations are not usually performed in clinical laboratories, probably due to inherent problems associated with the conventional methods, based on an emulsified lipid substrate. The methods are also not very suitable for manual batch analysis nor for automation due to laborious post incubation procedures. 

Ion-selective electrodes have been well received in the clinical laboratory and have allowed electrolyte panels to be routinely run on automated analyzers. The con-... 

An Introduction to Laboratory Automation. By Victor Cerda and Guillermo Ramis Gas Chromatography Biochemical, Biomedical, and Clinical Applications. Edited by Ray E. Clement... 

Immunocytochemical methods have become an integral part of the clinical laboratory, as well as the research setting (see Chapter 50). Clinically relevant specimens ranging from frozen sections and cell-touch preparations to whole-tissue samples are amenable to analysis (see Chapters 9-13). Panels of antibodies have been developed to aid in the differential diagnosis of tumors (see Chapter 51), and automated instrumentation has been designed to speed the handling of numerous specimens (see Chapter 52). 

In the past, laboratories have justified the initial investment in dedicated automation on the basis of the large number of identical, repetitive operations carried out. Fixed or dedicated automation is utihzed for large quantities of standard procedures, such as those found in manufacturing environments or in clinical laboratories. Fixed automation follows a predetermined sequence of steps to perform a defined procedure although efficient, it can only perform one repetitive procedure. Robotics, however, can provide flexible automation to meet the changing needs typical of quality control and research laboratories. Flexible automation is programmed by individual users to perform multiple procedures, and can be quickly reprogrammed to accommodate new or revised procedures. In these situations, a careful assessment of the software overhead must be made before a decision to purchase is made. 

Automated, High-Resolution Analyses for the Clinical Laboratory by Liquid Column Chromatography... 

Automated Laboratory Standards Evaluation of the Standards and Procedures Used in Automated Clinical Laboratories, Draft. May 1990. 

Lim CK, Peters TJ (1984) Urine and faecal porphyrin profiles by reversed-phase high-performance liquid chromatography in the porphyrias. Clin Chim Acta 139 55-63 Minder El, Vuilleumier JP, Vonderschmitt DJ (1992) Prototype application of robot in the clinical laboratory enabling fully automated quantification of fecal porphyrins. Clin Chem 38 516-521... 

Clinical chemistry, initiated in the 1940s. involves the biochemical testing of body fluids to provide objective information on which to base clinical diagnosis. The ever-increasing demand for high quality, routine clinical testing stimulated the development of automated techniques, and as early as the 1960s automation in the clinical laboratory was the rule rather than tlie exception. 

Automation in the Clinical Laboratory Biosensor Design and Fabrication Capillary Electrophoresis in Clinical Chemistry DNA Arrays Preparation and Application Drugs of Abuse, Analysis of Molecular Biological Analyses and Molecular Pathology in Clinical Chemistry Nucleic Acid Analysis in Clinical Chemistry Phosphorescence, Fluorescence, and Chemiluminescence in Clinical Chemistry Product Development for the Clinical Laboratory... 

Note Data may include computer printouts, magnetic media, and recorded data from automated instruments that are the result of the original observations, and activities of a non-clinical laboratory study necessary for the reconstruction and evaluation of the study report (electronic copies of electronic record files can be considered electronic record files provided that the data transfer processes have been verified). 

It can be said that to date there has been relatively little use for automatic colorimetric reading and recording devices in clinical laboratories. Further use of these will undoubtedly come about as laboratories begin to accept the more fully automated processes of analysis of the type described in the following sections. 

As can readily be seen, there is a considerable technological and electrical complexity involved in this automated scheme of chemical analysis. The cost of complete automation of a clinical laboratory would be outside the reach of most clinical laboratories. However, there are certain units described which might be applicable in large laboratories as individual aids, e.g., automatic dispensing pipets. 

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