Dear James (and others),
Thanks for raising this issue. My understanding in Australia is that most labs do
not use P5P with the exception of at least one supplier where there is only a P5P
option.
I think the reasons include the following: needing to add an additional component
to the reagents (which can be forgotten), reduced stability of the reagent
(anecdotal - I am it sure if this is true), "historical" (we have always done it
that way), the overhead of changing which involves changing the reference
intervals.
Against this would be the benefits: more stable patient samples, no falsely low
results in P5P deficient patients, true use of IFCC traceable results.
I note that while we sometimes complain about different companies having
different standardisations for the same test, this is largely in our hands as
companies often provide both - but we have not acted on it.
I would agree with an earlier comment today on the mailbase that most labs are
happy to change something for greater standardisation, we just do not want to
change twice. Thus a change from non-P5P to P5P with a change in reference
interval, may need to be followed with another change in reference interval if a
common reference interval is developed. If we could make the changes at the same
time....
(note these are personal opinions only)
Regards,
Graham
>>> "Miller,James J." <[log in to unmask]> 11/02/2013 8:49 am >>>
I posted a similar question on the MEDLAB list, which has largely U.S.
subscribers, but I wanted to get input from the U.K. and other countries in the
world as well.
I believe most of the world uses ALT & AST methods that include pyridoxal
phosphate (P5P) as recommended by the IFCC. In the U.S. it seems that most labs
use methods that omit P5P, even though most manufacturers offer both versions (at
least in the U.S.).
If your lab's ALT and/or AST methods do not contain P5P, could you tell me why?
Thanks. -Jim
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