{"id":146985,"date":"2019-06-11T03:50:54","date_gmt":"2019-06-11T03:50:54","guid":{"rendered":"https:\/\/labinsights.com\/acf_article\/3-buoc-de-giam-thieu-tac-dong-cua-nhieu-xet-nghiem\/"},"modified":"2026-02-25T11:29:14","modified_gmt":"2026-02-25T11:29:14","slug":"3-steps-to-mitigate-the-impact-of-interference","status":"publish","type":"acf_article","link":"https:\/\/labinsights.com\/vi\/disease-area\/coagulation\/steps-to-mitigate-the-impact-of-interference\/","title":{"rendered":"3 b\u01b0\u1edbc \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u00e1c \u0111\u1ed9ng c\u1ee7a nhi\u1ec5u x\u00e9t nghi\u1ec7m"},"content":{"rendered":"\t\t
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The widely used dietary supplement, vitamin B7 or biotin, raised concerns last year. It was found to\u00a0interfere with some lab tests, prompting the US Food &\u00a0Drug Administration (FDA) to issue a\u00a0warning. Such interference is not new to laboratory medicine and will continue to be an issue as new\u00a0drugs, tests and supplements come to market. And it does not only affect laboratory-based tests,\u00a0even simple point-of-care glucose metres and pregnancy tests are affected.<\/p>

But to an increasingly lean laboratory medicine team, interference poses another threat. Following\u00a0advances in automation and big data analysis, many labs today can run a full day-to-day volume of\u00a0various chemistry samples with just two laboratory scientists manning the line. But when a call back\u00a0comes because of an unusual result, this carefully honed operating model is challenged, upsetting\u00a0the downstream testing process. In that team of two, one would have to troubleshoot, affecting the\u00a0team\u2019s ability to report urgent values or handle priority samples from patients with life threatening\u00a0health concerns.<\/p>

While interference cannot always be predicted, there are plenty of areas where it can be prevented.\u00a0Here are three steps to mitigate the impact of preventable interference such as that caused by biotin\u00a0to help lab teams remain efficient and effective.<\/p>

Step 1: Education of providers and patients<\/h2>

As laboratory medicine experts, it is our duty to step outside the laboratory and educate our\u00a0customers \u2013 whether that is the patient or his care provider. Through presentations to physicians at\u00a0hospital Grand Rounds, conferences or even blog posts and email alerts, we need to build\u00a0partnerships and understanding to support the dissemination of knowledge.<\/p>

At UC Davis, we launched a laboratory best practice blog [1]\u00a0about two years ago. Aimed at providers,\u00a0we post one entry a month covering important topics, such as interference.\u00a0But we must not forget the patient. In the case of biotin or other preventable sources of\u00a0interference, we need to educate patients about how to prepare for their test, through means such\u00a0as instructional leaflets or reminders.<\/p>

Step 2: Surveillance<\/h2>

The second strand is surveillance. To ensure the right educational efforts are put in place, it is\u00a0paramount to understand what a lab\u2019s local population or even national population looks like. For\u00a0example, is biotin actually a common supplement in that population and in doses that are likely to\u00a0be detectable? Compiling data from a lab\u2019s own records as well as databases such as the FDA’s Manufacture and User Facility Device Experience (MAUDE) [2]\u00a0helps to build that picture.<\/p>

For example in the case of biotin use, the MAUDE database shows that the vast majority of tests that\u00a0threw up biotin interference involved patients with multiple sclerosis. These patients would be\u00a0taking in excess of 100 mg of biotin per day in an off-label use of the supplement. However, this is\u00a0something that laboratory team together with care teams can probe for during history taking and\u00a0plan for when scheduling tests.<\/p>

At UC Davis, we went a step further as we wanted to find out whether biotin interference was likely\u00a0in our patient population. We examined the electronic health records of more than 800 patients and determined that none of the patients had concentrations of biotin that approached the level where\u00a0it would interfere with the assay.<\/p>

However, following the FDA\u2019s alert that biotin could interfere with troponin measurements, we conducted a multi-centre review of 1,443 samples from 850 patients. We found that biotin levels\u00a0were detected in fewer than half of them. Again, this reassured us that biotin interference is likely to\u00a0be highly uncommon in our patient population, despite the media headlines.<\/p>

Step 3: Proactiveness<\/h2>

The last prong is to take a proactive stance to manage potential interferences before they affect\u00a0laboratory processes. At UC Davis, have evaluated an electronic early warning into our system. This\u00a0alerts the provider and the lab that the test ordered could be affected by biotin interference.\u00a0However, we have to be aware that such alerts are often ignored as data has shown that almost\u00a0three in four medication-related electronic health system alerts are overridden by the user. This,\u00a0therefore, cannot be the only strategy, but it can serve as a last line of defence.<\/p>

Mitigating the disruption caused by preventable interference requires an integrated, evidence-based\u00a0strategy. Understanding the patient population is key to assessing the likelihood of a given\u00a0substance\u2019s interference in laboratory testing. Some interference such as heterophile interference\u00a0cannot be predicted or prevented. But where interference can be prevented, it is crucial that we in\u00a0laboratory medicine proactively support the physicians and patients with the right education to\u00a0ensure that it is prevented. As with all aspects of healthcare, prevention is always better than\u00a0treatment.<\/p>

[1] <\/a>“UC Davis Health Lab Best Practice”\u00a0https:\/\/health.ucdavis.edu\/blog\/lab-best-practice<\/a><\/p>

[2]<\/a>\u00a0“MAUDE – Manufacture\u00a0and User Facility Device Experience”, US Department of Health and Human Services<\/p>

This article is based on the presentation: <\/em>Immunoassay interferences: Facts, insights and a pragmatic approach\u00a0at the Roche Efficiency Days (RED) 2018 REDefining perspective in Guangzhou, China.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

The widely used dietary supplement, vitamin B7 or biotin, raised concerns last year. It was found to\u00a0interfere with some lab tests, prompting the US Food &\u00a0Drug Administration (FDA) to issue a\u00a0warning. Such interference is not new to laboratory medicine and will continue to be an issue as new\u00a0drugs, tests and supplements come to market. And […]<\/p>\n","protected":false},"author":1,"featured_media":83635,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"unboxed","site-sidebar-style":"unboxed","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"tags":[14754],"pillarandcategory":[292,304,282,300],"reporter":[14802],"class_list":["post-146985","acf_article","type-acf_article","status-publish","has-post-thumbnail","hentry","tag-gia-tri-lam-sang","pillarandcategory-coagulation","pillarandcategory-clinician-engagement","pillarandcategory-disease-area","pillarandcategory-management","reporter-nam-k-tran"],"acf":[],"_links":{"self":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/146985","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article"}],"about":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/types\/acf_article"}],"author":[{"embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":5,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/146985\/revisions"}],"predecessor-version":[{"id":149429,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/acf_article\/146985\/revisions\/149429"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/media\/83635"}],"wp:attachment":[{"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/media?parent=146985"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/tags?post=146985"},{"taxonomy":"pillarandcategory","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/pillarandcategory?post=146985"},{"taxonomy":"reporter","embeddable":true,"href":"https:\/\/labinsights.com\/vi\/wp-json\/wp\/v2\/reporter?post=146985"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}