ABSTRACT
Our study aimed to evaluate and validate according to standard NF EN ISO 15189 the original protocol ajustement of Hemoclot Protein C (PC) (Hyphen BioMed), clotting-based assay of PC on ACL TOP analyzer (Werfen/Instrumentation Laboratory). We evaluated the performance in terms of imprecision and we validate additional parameters in range B required by the SH GTA 04 (COFRAC): repeatability, reproducibility, detection and quantification limits, limits of linearity, stability, inter-samples and inter-reagents contamination, inaccuracy, evaluation of interferences (hemolysis, bilirubinemia and chyles). A comparison with Hemoclot PC on STA Compact analyzer (Stago) was performed. Coefficients of variation were lower than 5 %. Detection and quantification limits were respectively 8.3 % and 9.3 %. Superior limit of linearity was 140 %. The test didn't diplay any inter-samples and inter-reagents contamination. Reagent after reconstitution was stable 6 hours on ACL TOP. No interferences were observed for hemoglobin lower than 500 mg/dL, for bilirubin lower than and for chyles lower than 300 mg/dL. Comparison with Hemoclot PC on STA analyzer (Stago) was satisfactory. Hemoclot PC adjusted on ACL TOP analyzer showed satisfactory analytical performances with criteria chosen in our study. These data allow a better knowledge of the performances of this test and were useful to make a validation file in range B as recommended by SH GTA 04.
Subject(s)
Automation, Laboratory/instrumentation , Protein C/analysis , Accreditation , Artifacts , Blood Coagulation Disorders/blood , Blood Coagulation Disorders/diagnosis , Blood Coagulation Tests/instrumentation , Blood Coagulation Tests/methods , Blood Coagulation Tests/standards , Diagnostic Errors , Drug Stability , Equipment Contamination , Humans , Reagent Kits, Diagnostic/standards , Reproducibility of Results , Specimen Handling/methodsABSTRACT
BACKGROUND: The causes of prolonged disability due to back pain are multiply determined, involving medical, social, and environmental factors. Possible solutions to the problem of prolonged back pain disability have emerged from recent research but few efforts have been made to transfer evidence-based programs to large community settings. OBJECTIVE: This article describes three phases of the process of transfer of evidence from rehabilitation research to community practice in the province of Quebec. METHODS AND RESULTS: Phase A: Based on literature review and expert knowledge, the Sherbrooke model was developed and assessed through a population-based, randomized clinical trial. Results at 1-year follow-up showed quicker return to regular work and improvement of quality of life; the 6-year follow-up showed the cost-effectiveness of the method. Phase B: Based on the Sherbrooke model experience and recent evidence, a new program addressing the disability paradigm was developed and implemented in the province of Quebec (Canada). Results at 1- and 3-year follow-ups showed that only 24% of workers were not working owing to their musculoskeletal disorder. The program is presently being tested through a population-based, randomized clinical trial in a population of construction workers. Phase C: To implement the program at a provincial level, a network for management, research and education in work rehabilitation was developed. An external assessment is presently planned to evaluate return to work and economic outcomes and quality of implementation of the program in various settings.
Subject(s)
Back Pain/epidemiology , Community Health Services/methods , Disability Evaluation , Evidence-Based Medicine/methods , Occupational Diseases/epidemiology , Occupational Diseases/rehabilitation , Occupational Therapy/methods , Adult , Back Pain/classification , Back Pain/diagnosis , Back Pain/etiology , Back Pain/rehabilitation , Clinical Protocols , Clinical Trials as Topic , Cohort Studies , Employment/statistics & numerical data , Female , Health Status , Health Status Indicators , Humans , Male , Musculoskeletal Diseases/complications , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/rehabilitation , Occupational Diseases/complications , Patient Care Team/organization & administration , Quebec/epidemiologyABSTRACT
Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disability resolution in patients absent from work due to a musculoskeletal disorder. Initial application demonstrated a high prevalence of sociodemographic, work-related, and psychosocial factors that may contribute to prolonged work absence.
