Quality Assessment of Dried Blood Spots from Patients With Tuberculosis from 4 Countries

Zuur, Marlanka A; Veenhof, Herman; Aleksa, Alena; Boveneind-Vrubleuskaya, Natascha van 't; Darmawan, Endang; Hasnain, Golam; Heysell, Scott K; Jongedijk, Erwin M; Koster, Remco A.; Magis-Escurra, Cécile; Martinez, Nilza; Molinas, Gladys; Mondal, Dinesh; Mulyani, Ully Adhie; Perwitasari, Dyah A; Tsivunchyk, Andrej; Touw, Daan; Alffenaar, Jan-Wilem C

doi:10.1097/ftd.0000000000000659

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…Because the WB samples were part of routine care, they were analyzed within a day. After receiving the DBS and VAMS samples, they were inspected independently by two experienced lab technicians for quality, based on predefined criteria described earlier [15,27,30,31]. If the judgment of the technicians differed, consensus was obtained by discussing each other's judgment.…”

Section: Ethical Approval Patients Sample Collection and Sample Quamentioning

confidence: 99%

“…Several of these DBS methods have shown to yield interchangeable results with venous whole blood (WB) and are routinely applied in transplant patient care, including in our hospital [2,3,11,13]. A drawback of DBS application is that sampling by the patient does not always lead to sufficient quality DBS samples, and rates of up to 20% invalid samples for patient home sampled DBS have been reported [11,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring

Veenhof

Koster

Junier

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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ObjectivesMonitoring tacrolimus blood concentrations is important for preventing allograft rejection in transplant patients. Our hospital offers dried blood spot (DBS) sampling, giving patients the opportunity to sample a drop of blood from a fingerprick at home, which can be sent to the laboratory by mail. In this study, both a volumetric absorptive microsampling (VAMS) device and DBS sampling were compared to venous whole blood (WB) sampling.MethodsA total of 130 matched fingerprick VAMS, fingerprick DBS and venous WB samples were obtained from 107 different kidney transplant patients by trained phlebotomists for method comparison using Passing-Bablok regression. Bias was assessed using Bland-Altman. A multidisciplinary team pre-defined an acceptance limit requiring >80% of all matched samples within 15% of the mean of both samples. Sampling quality was evaluated for both VAMS and DBS samples.Results32.3% of the VAMS samples and 6.2% of the DBS samples were of insufficient quality, leading to 88 matched samples fit for analysis. Passing-Bablok regression showed a significant difference between VAMS and WB, with a slope of 0.88 (95% CI 0.81–0.97) but not for DBS (slope 1.00; 95% CI 0.95–1.04). Both VAMS (after correction for the slope) and DBS showed no significant bias in Bland-Altman analysis. For VAMS and DBS, the acceptance limit was met for 83.0% and 96.6% of the samples, respectively.ConclusionsVAMS sampling can replace WB sampling for tacrolimus trough concentration monitoring, but VAMS sampling is currently inferior to DBS sampling, both regarding sample quality and agreement with WB tacrolimus concentrations.

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Section: Ethical Approval Patients Sample Collection and Sample Quamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring

Veenhof

Koster

Junier

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…9 Other studies focused on the feasibility of DBS home sampling in the context of patient sampling performance and sample quality. [10][11][12][13][14] Given that using DBS home sampling could result in up-todate blood levels of tacrolimus readily available at every consultation, we hypothesized that implementing DBS would increase the rate of tapering of outpatient visits and therefore would lower total health care costs. In this randomized controlled hybrid implementation trial, we aimed to assess whether the use of DBS home sampling in the first 6 months after kidney transplantation would result in fewer clinical consultations and lower costs from a societal perspective compared to usual care.…”

Section: Introductionmentioning

confidence: 99%

“…Only 1 study addressed the feasibility and implementation of home‐based microsampling for tacrolimus TDM in children, but this study lacked a control group . Other studies focused on the feasibility of DBS home sampling in the context of patient sampling performance and sample quality …”

Section: Introductionmentioning

confidence: 99%

Effects, costs and implementation of monitoring kidney transplant patients' tacrolimus levels with dried blood spot sampling: A randomized controlled hybrid implementation trial

Veenhof

Boven

Voort

et al. 2020

Brit J Clinical Pharma

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Aims: Dried blood spot (DBS) home sampling allows monitoring creatinine levels and tacrolimus trough levels as an alternative for blood sampling in the hospital, which is important in kidney transplant patient follow-up. This study aims to assess whether DBS home sampling results in decreased patient travel burden and lower societal costs. Methods: In this single-centre randomized controlled hybrid implementation trial, adult kidney transplant patients were enrolled. The intervention group (n = 25) used DBS home sampling on top of usual care in the first 6 months after transplantation. The control group (n = 23) received usual care only. The primary endpoint was the number of outpatient visits. Other endpoints were costs per patient, patient satisfaction and implementation.Results: There was no statistically significant difference in the average number of outpatient visits between the DBS group (11.2, standard deviation: 1.7) and the control group (10.9, standard deviation: 1.4; P = .48). Average costs per visit in the DBS group were not significantly different (€542, 95% confidence interval €316-990) compared to the control group (€533, 95% confidence interval €278-1093; P = .66).Most patients (n = 19/23, 82.6%) were willing to perform DBS home-sampling if this would reduce the number of hospital visits. Only 55.9% (n = 143/256) of the expected DBS samples were received and 1/5 analysed on time (n = 52/256). Conclusion: Adult kidney transplant patients are willing to perform DBS home sampling. However, to decrease patient travel burden and costs in post-transplant care, optimization of the logistical process concerning mailing and analysis of DBS samples is crucial. K E Y W O R D S cost-effectiveness, dried blood spots, implementation, randomized controlled trialThe authors confirm that the Principal Investigator for this paper is Daniël Johannes Touw and that he had direct clinical responsibility for the patients in this trial.

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“…Dried blood spots (DBS) is a well-established method to screen neonates for in-borne disease and has also been used to detect antibodies against viruses 16 . However, measurements of DBS are often not accurate enough 17 , and self-sampling by patients is difficult leading to significant failure rates 18 . To address these issues, devices that simplify sampling and provide precise volumes have been developed 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Multianalyte serology in home-sampled blood enables an unbiased assessment of the immune response against SARS-CoV-2

et al. 2021

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Serological testing is essential to curb the consequences of the COVID-19 pandemic. However, most assays are still limited to single analytes and samples collected within healthcare. Thus, we establish a multianalyte and multiplexed approach to reliably profile IgG and IgM levels against several versions of SARS-CoV-2 proteins (S, RBD, N) in home-sampled dried blood spots (DBS). We analyse DBS collected during spring of 2020 from 878 random and undiagnosed individuals from the population in Stockholm, Sweden, and use classification approaches to estimate an accumulated seroprevalence of 12.5% (95% CI: 10.3%–14.7%). This includes 5.4% of the samples being IgG+IgM+ against several SARS-CoV-2 proteins, as well as 2.1% being IgG−IgM+ and 5.0% being IgG+IgM− for the virus’ S protein. Subjects classified as IgG+ for several SARS-CoV-2 proteins report influenza-like symptoms more frequently than those being IgG+ for only the S protein (OR = 6.1; p < 0.001). Among all seropositive cases, 30% are asymptomatic. Our strategy enables an accurate individual-level and multiplexed assessment of antibodies in home-sampled blood, assisting our understanding about the undiagnosed seroprevalence and diversity of the immune response against the coronavirus.

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Quality Assessment of Dried Blood Spots from Patients With Tuberculosis from 4 Countries

Cited by 14 publications

References 19 publications

Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring

Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring

Effects, costs and implementation of monitoring kidney transplant patients' tacrolimus levels with dried blood spot sampling: A randomized controlled hybrid implementation trial

Multianalyte serology in home-sampled blood enables an unbiased assessment of the immune response against SARS-CoV-2

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