I would like to know if, and how, others are carrying out dual reporting of
HbA1c, which should have been started June this year.
Our instrument supplier TOSOH, have made a software adjustment as follows.
HbA1c calibrated against DCCT standard
HbA1c (IFCC) calculated using agreed equation.
HbA1c (DCCT) back calculated from HbA1c (IFCC) and only this is reported
out of analyser to their data station, so only HbA1c (DCCT) sent to LIS.
So, we could use the same equation in the LIS to re-calculate HbA1c (IFCC),
(how far removed is that from the original calibration???) as a calculated
result, and then report both DCCT and IFCC values.
However, at some time in the future, possibly in December, they will start
calibrating against an IFCC standard, and then calculating the DCCT value,
with the option, we are told to output either DCCT or IFCC, but not both
My concern is that at some time in the future, we will need to bite the bullet
and report the HbA1c (IFCC) value from the analyser, and immediatley we
start that, then on the LIS we will lose the historical data from the reports, as
there would be 3 test codes for HbA1c in the LIS, so continuity of care and
looking back at results will be a nightmare, as we will have
HbA1c (DCCT) - measured
HbA1c (IFCC) - calculated
HbA1c (IFCC) - measured
I would be interested to hear how others are approaching this, and indeed to
know what discussion has been undertaken with pharmaceutical companies, as
today there were 2 reps touting their products for Diabetes, both of which
show 1% reduction in HbA1c (DCCT) levels, but nowhere was there any
mention of the comparible HbA1c (IFCC) values, nor were they aware of what
the new values should be.
Clearly we are at the early stages of this process, but I really do not want to
wait to see what the suppliers come up with at the end of December, which is
when they argue they are required to make this switch, and therefore reduce
the time doctors and patients have come to understand the new treatment
Consultant in Clinical Biochemistry
Worcestershire Acute Hospitals HNS Trust.
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
List Instructions (How to leave etc.)