Evidence map›Paper›PMID 33728249›Full record

ArticleJIMD reports2021

Monitoring phenylalanine concentrations in the follow-up of phenylketonuria patients: An inventory of pre-analytical and analytical variation.

Karlien L M Coene, Corrie Timmer, Susan M I Goorden, Amber E Ten Hoedt, Leo A J Kluijtmans, Mirian C H Janssen, Alexander J M Rennings, Hubertus C M T Prinsen, Mirjam M C Wamelink, George J G Ruijter and 7 more

Open access · goldAbstract read
In one paragraph

Article in JIMD reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 7 institutions in 1 country.

Karlien L M CoeneTranslational Metabolic Laboratory, Department of Laboratory Medicine Radboud University Medical Centre Nijmegen The Netherlands.ORCID https://orcid.org/0000-0001-9873-1458
Corrie TimmerDepartment Endocrinology and Metabolism Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.ORCID https://orcid.org/0000-0002-9440-9645
Susan M I GoordenLaboratory Genetic Metabolic Diseases, Department of Clinical Chemistry Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.
Amber E Ten HoedtDepartment of Paediatrics, Division of Metabolic Disorders Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.
Leo A J KluijtmansTranslational Metabolic Laboratory, Department of Laboratory Medicine Radboud University Medical Centre Nijmegen The Netherlands.
Mirian C H JanssenDepartment of Internal Medicine Radboud University Medical Centre Nijmegen The Netherlands.
Alexander J M RenningsDepartment of Internal Medicine Radboud University Medical Centre Nijmegen The Netherlands.
Hubertus C M T PrinsenSection Metabolic Diagnostics, Department of Genetics UMC Utrecht Utrecht The Netherlands.
Mirjam M C WamelinkMetabolic Laboratory, Department of Clinical Chemistry Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands.
George J G RuijterCenter for Lysosomal and Metabolic Diseases, Department of Clinical Genetics Erasmus MC Rotterdam The Netherlands.
Irene M L W Körver-KeulartsLaboratory of Biochemical Genetics, Department of Clinical Genetics Maastricht University Medical Centre Maastricht The Netherlands.
M Rebecca Heiner-FokkemaLaboratory of Metabolic Diseases University of Groningen, University Medical Center Groningen Groningen The Netherlands.
Francjan J van SpronsenDivision of Metabolic Diseases Beatrix Children's Hospital, University Medical Centre Groningen Groningen The Netherlands.
Carla E HollakDepartment Endocrinology and Metabolism Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.
Frédéric M VazLaboratory Genetic Metabolic Diseases, Department of Clinical Chemistry Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.
Annet M BoschDepartment of Paediatrics, Division of Metabolic Disorders Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands.
Marleen C D G HuigenTranslational Metabolic Laboratory, Department of Laboratory Medicine Radboud University Medical Centre Nijmegen The Netherlands.
Amsterdam Neuroscience · NLRadboud University Nijmegen · NLUniversity Medical Center Groningen · NLAmsterdam University Medical Centers · NLErasmus MC · NLMaastricht University Medical Centre · NLUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReliable measurement of phenylalanine (Phe) is a prerequisite for adequate follow-up of phenylketonuria (PKU) patients. However, previous studies have raised concerns on the intercomparability of plasma and dried blood spot (DBS) Phe results. In this study, we made an inventory of differences in (pre-)analytical methodology used for Phe determination across Dutch laboratories, and compared DBS and plasma results.

methodsThrough an online questionnaire, we assessed (pre-)analytical Phe measurement procedures of seven Dutch metabolic laboratories. To investigate the difference between plasma and DBS Phe, participating laboratories received simultaneously collected plasma-DBS sets from 23 PKU patients. In parallel, 40 sample sets of DBS spotted from either venous blood or capillary fingerprick were analyzed.

resultsOur data show that there is no consistency on standard operating procedures for Phe measurement. The association of DBS to plasma Phe concentration exhibits substantial inter-laboratory variation, ranging from a mean difference of -15.5% to +30.6% between plasma and DBS Phe concentrations. In addition, we found a mean difference of +5.8% in Phe concentration between capillary DBS and DBS prepared from venous blood.

conclusionsThe results of our study point to substantial (pre-)analytical variation in Phe measurements, implicating that bloodspot Phe results should be interpreted with caution, especially when no correction factor is applied. To minimize variation, we advocate pre-analytical standardization and analytical harmonization of Phe measurements, including consensus on application of a correction factor to adjust DBS Phe to plasma concentrations.

Indexed as

bloodspotDBShyperphenylalaninemialaboratory variationmeasurementphenylalaninephenylketonuriaPKU

Identifiers

PMID33728249
PMCPMC7932865
OpenAlexW3109998922

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.