Impact of the loss of Laboratory Developed Mass Spectrometry testing at a major academic medical center

© 2023 THE AUTHORS..

Background: Our laboratory historically performed immunosuppressant and definitive opioid testing in-house as laboratory developed (LDT) mass spectrometry-based tests. However, staffing constraints and supply chain challenges associated with the COVID-19 pandemic forced us to refer this testing to a national reference laboratory. The VALID Act could impose onerous requirements for laboratories to develop LDTs. To explore the potential effect of these additional regulatory hurdles, we used the loss of our own LDT tests to assess the impact on patient care and hospital budgets.

Methods: Laboratory information systems data and historical data associated with test costs were used to calculate turnaround times and financial impact.

Results: Referral testing has extended the reporting of immunosuppressant results by an average of approximately one day and up to two days at the 95th percentile. We estimate that discontinuing in-house opioid testing has cost our health system over half a million dollars in the year since testing was discontinued.

Conclusions: Barriers that discourage laboratories from developing in-house testing, particularly in the absence of FDA-cleared alternatives, can be expected to have a detrimental effect on patient care and hospital finances.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:28

Enthalten in:

Journal of mass spectrometry and advances in the clinical lab - 28(2023) vom: 15. Apr., Seite 63-66

Sprache:

Englisch

Beteiligte Personen:

Geno, K Aaron [VerfasserIn]
Cervinski, Mark A [VerfasserIn]

Links:

Volltext

Themen:

CLIA
CLIA, clinical laboratory improvement amendments
Cyclo A, cyclosporine A
EUA, emergency use authorization
FDA
FDA, food and drug administration
ISD, immunosuppressant drug monitoring
IVD, In-vitro diagnostic
Journal Article
LCMS, liquid chromatography mass spectrometry
LDT
LDT, laboratory developed test
Laboratory developed test
MS, mass spectrometry
TAT, turnaround time
TDM, therapeutic drug monitoring
VALID, verifying accurate leading-edge IVCT development
VALID Act

Anmerkungen:

Date Revised 06.03.2023

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.jmsacl.2023.02.005

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM353521469