Autoanalysers/automation Flashcards

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1
Q

Why were autoanalysers built?

A
  • Originally the Biochemistry laboratory used to perform tests manually
  • The first automated analyser “AutoAnalyzer” was introduced in 1957 (20 samples at a time)
  • Autoanalysers have been built in response to demand – ~2,000 samples daily and your average sample has 10 tests requested on it!
  • Creatinine’s used to go from 30 a day to 3,000!
  • Increase turnaround times (from 2 hours to 15 minutes!)
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2
Q

How do autoanalysers modernising pathology

A
  • Standardise testing and improve resilience
  • Improve quality and efficiency
  • Manage demand and improve value for money
  • Invest in the latest technologies
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3
Q

What are the benefits of autoanlysers to patients, staff and the NHS

A

Patients – Improved access to specialist tests, sharing results across sites

Staff- Training and development

NHS – Save and re-invest that money

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4
Q

Automation vs Mechanisation

A

Mechanisation:

• Using devices to replace, refine or extend human effort: e.g. capping/de-capping

Automation:

• Mechanisation with process control and use of computers helps with aspects of this: e.g. sample analysis

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5
Q

What happened before automation:

A
  • All steps performed manually
  • High chance of human error
  • Time consuming
  • Lost/Misplaced/wasted samples
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6
Q

What does automation allow?

A
  • Electronic bar-coding for identification and test requests
  • Tracking of sample throughout process
  • Automatic aliquot for the sharing of samples
  • Automated analysis on multi assay analysers on a single sample
  • Electronic result collection and reporting
  • Minimal variation and error
  • Less sample and reagent
  • Reflex testing
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7
Q

Types of analyser: Continuous flow

A

Tubing flow of reagents and patient samples, separated by air bubbles

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8
Q

Types of analyser: Centrifugal

A

Use of centrifugal force to mix a sample aliquot with a reagent and a spinning rotor and to pass the reaction mixture through a detector

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9
Q

Types of analyser: Discrete

A

• Robotic sampling arm and the use of single testing cuvettes for each reaction and only perform tests ordered on each sample

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10
Q

Explain how continuous flow analysers work

A
  • Samples, reagents and diluents are introduced into a system of continuous tubing
  • Spectrophotometric
  • Sample probe placed in distilled water
  • Does not allow test selection – all tests are performed even if they have not been requested
  • Machine runs continuously and continually draws in reagents (costly and wasteful!)
  • Monitor for bubble uniformity in the tubing
  • Large machines
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11
Q

How do centrifugal analysers work?

What are the advantages and disadvantages?

A

Introduced in 1968

  • Sample and reagent are pipetted into a cuvette
  • Sample and reagent is mixed and the rotor containing the cuvette is spun and mixture flows over the walls into the reaction chamber – followed by a sudden stop
  • Advantages include small sample and reagent volumes
  • Disadvantages include that only one analyte can be measured each time (batch analyser)
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12
Q

How do discrete analysers work?

What are the advantages and disadvantages?

A
  • Sample and reagent are added to an individual cuvette or reaction vessel
  • Can run multiple tests on one sample (each sample is treated independently)
  • Multiple samples one test at a time
  • High throughput • Small sample volume
  • Reaction chamber is temperature controlled
  • Random access
  • Almost completely replaced flow and centrifugal
  • Costly
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13
Q

Workflow engineering:

Continuous flow

A

Sequential or Parallel

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14
Q

Workflow engineering:

Random acess

A
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15
Q

Random Access – STAT

A

Urgent Samples

• Can’t afford to waste time – front loading?

Re-runs

• LIMS error? Sample error? Bubble? Barcode error?

Add-ons

• If it’s urgent, do you have time to run it with routine samples?

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16
Q

Reflex Testing

A
  • Consent forms an essential part of laboratory testing
  • Occasionally, additional tests can be performed to support diagnosis
  • Done without requesters consent
  • For example, a patient has an abnormal TSH – reflex for free T4
  • Done automatically
17
Q

Workflow analysis:

A

o Strengths and weaknesses of the current system (workload too high)

o Changes in workload (time saving, increase productivity, increase quality and reduce cost)

o Process is safer

18
Q

Modular Automation

A
  • Perform routine chemistries, immunoassays and serology
  • For example, link a chemistry and immunoassay platform, forming a small workcell
  • Link an ISE module to a chemistry module and an immunoassay module
19
Q

What are the benefits of modular automation?

A
  • Reduce risk of sample contamination or injury
  • Easier to track samples
  • Reduction in aliquoting and capping/uncapping samples
20
Q

What are the components of an analyser?

A
21
Q

Total automation-Abbott

A
22
Q

There are a number of considerations to make when getting new equipment:

A
  • Instrument’s throughput capability (which can reach up to 10,000 combined ISE and colorimetric tests per hour) testing speed
  • Test menu • STAT mode or random-access
  • Is batch, random, or continuous analysis preferred?
  • Additional testing in the future
  • Cost: reagents/consumables/service
  • Sample handling, ability to work with microvolumes
  • Laboratories handling thousands of tests per hour will require bar-code handling and data management software
23
Q

Instrument evaluation

A
  • Run routine samples on the “old” analyser and run them on the new analyser for comparison
  • Differences in methodology and results?
  • Statistically analyse data to see variation
24
Q

Quality Assurance:

How do you know the results you obtain and report are accurate?

A

Quality Controls

  • Internal quality controls (IQC)
  • In-house controls (Patient samples)
  • Kit controls (Supplier)
  • Calibrators
  • UKAS – ISO15189
  • Batch testing
  • Compare performance
25
Q

UKNEQAS

A
  • Nationwide scheme
  • Samples received and send results back
  • Monitor performance
  • NQAAP
  • JWG
26
Q

Levey-Jennings

A
  • Monitor assay performance using a Levey-Jennings plot
  • Mean is plotted and values within +/- 2SD are usually accepted
  • Series of data points that allows you to monitor precision and accuracy
  • Apply the Westgard rules – 6 rules to evaluate the assay performance - Random and Systematic errors
27
Q

The Biomedical Scientist

A
  • Pre-analytical processing
  • Sample issues
  • Add-ons
  • Daily/Weekly/Monthly Maintenance
  • Calibration
  • QC
  • UKNEQAS
  • Result reporting
  • Training
  • Complicated assays