Has the NEQAS questionnaire been sent to all Northstar users? We at Barts can find no record of it.
Best wishes
Anne
Dr Anne Dawnay PhD FRCPath
Consultant Clinical Biochemist
Barts Health
Tel 020 7377 7000 ext 61030
Date: Thu, 9 Aug 2018 14:48:30 +0000
From: "FREDERICK,
Gina (UNIVERSITY HOSPITALS OF DERBY AND BURTON NHS FOUNDATION TRUST)"
<[log in to unmask]>
Subject: Re: Changes to software reporting of CSF bilirubin & Oxyhaemoglobin
To all Northstar users.
If you have received the questionnaire from NEQAS, regarding changes to the software for CSF Bilirubin and OxyHb, can I please urge you to complete it.
Many thanks
Gina
Pathology Lab
Royal Derby Hospital
________________________________
From: Clinical biochemistry discussion list <[log in to unmask]> on behalf of FREDERICK, Gina (DERBY TEACHING HOSPITALS NHS FOUNDATION TRUST) <[log in to unmask]>
Sent: 03 July 2018 11:47
To: [log in to unmask]
Subject: Changes to software reporting of CSF bilirubin & Oxyhaemoglobin
Dear Mailbase
Many thanks for all the replies to this post.
In summary - a lot of concern expressed regarding these changes.
Encouragingly some UK groups have standardised reporting of CSF Bili to 4 dec places and OxyHb to 3 dec places (The All-Wales Biochemistry Standardisation group)
The software company state they have upgraded their software to bring it into line with the new Immqas CSF Haem pigments decision tree (see attached) and the 2008 Xanthochromia guidelines, thereby limiting reporting of CSF Bili to 3 dec places and CSF OxyHb to 2 dec places. The scan report now adds the NEQAS reporting code to the interpretation. They say they have had a few complaints regarding 'false positive' reports when the CSF bili is 0.0071, 0.0072, 0.0073, 0.0074. So these changes appear to be focused around NEQAS samples, rather then patient focused.
Not all Labs have been informed of the implications before their software was changed.
Some Labs have asked to revert back to the old software and been informed that they can, but that the old software will no longer be supported.
Some Labs that were notified prior to the software changes have refused to allow it.
NEQAS didn't know about these changes to the software. The following is their response:
'We are hoping to circulate an email to all Northstar users in the next few weeks to determine which labs are using or thinking of using the updated software. We will then discuss within the specialist advisory group and decide on further actions/next steps, as we also have concerns regarding the changes.'
If anyone has any further comments or requires more information, please don't hesitate to get in touch.
Many thanks
Gina
(Royal Derby Hospital)
Dear Mailbase
We have recently had our software updated for reporting of CSF Bilirubin & Oxyhaemoglobin so that the decimal places are limited to two for OxyHb and three for Bilirubin. So we are seeing increasing numbers of reports with OxyHb = 0.00, and Bilirubin = 0.000 when there are clear peaks present (albeit still below the positive cut-off).
We have a couple of issues with this.
Firstly, staff are having to either manually calculate or hover the mouse over the scan to give a reading - there is potential for error here, especially in the middle of the night on a busy shift, as we offer a 24/7 service.
Secondly, we risk reporting a positive bilirubin as negative, if a result of 0.0074 is rounded down to 0.007. We are usually very cautious with borderline results anyway, but there is the potential to miss a borderline positive result.
Has anyone else had this happen, and does anyone know what has triggered this change to the software? I am trying to contact our software engineer, but in the meantime, would appreciate any thoughts/comments on this.
Many thanks
Gina
(Royal Derby Hospital)
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