In diagnostic testing errors can occur at any stage of testing, with pre-analytical interference from haemolysis, icterus, and lipaemia (HIL) being particularly common. HIL interference can lead to inaccurate results and is therefore a major concern for clinical laboratories. Jason Armstrong explores the causes and effects of HIL interference and discuss strategies for its detection and mitigation in clinical laboratory analysis.
Errors can occur at any stage in the pre-analytical, analytical, or post-analytical stage of a diagnostic test. It is general practice for errors in the analytical stage to be identified through quality control procedures. However, pre-analytical errors are often treated with less importance than those in later stages of testing. Interference caused by haemolysis, icterus and lipaemia (HIL) are common forms of pre-analytical error which affect assay methods, yielding erroneous results. HIL interference is not novel and has been historically identified through a series of visual assessments.
While haemolytic, icteric and lipaemic interference causes a visual change in the sample, these methods are not quantitative and are subject to interpretation by laboratory professionals. Modern analysers have built-in capabilities for the automated detection of HIL interference which can quantitatively or semi-quantitatively measure haemolysis, icterus and lipaemia, and provide and an index for each. This data can then be used to determine if a sample should be accepted for testing or rejected due to intrinsic interference.
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