2023 · Annals of clinical biochemistry · paywalled
Cross-sectional audit assessing the quality of dried bloodspot specimens received by UK metabolic biochemistry laboratories for the biochemical monitoring of individuals with Phenylketonuria
Hogg et al.
The finding, in our words
Patient-collected dried blood spot specimens for phenylketonuria monitoring showed significant quality variability across ten UK laboratories, with rejection rates rising from a median of 4.0% under existing local criteria to 21.9% under proposed national guidelines, most commonly because spots were too small or multi-spotted. The authors estimate that accepting poor-quality specimens could lead to approximately 12,410 incorrect results annually in England, and recommend ongoing training for patients and carers to prevent distress from higher rejection rates.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Enhanced visual and textual guidance significantly improved the quality of dried blood spots self-collected by children and adolescents, increasing the proportion of acceptable cards from 47.6% to 86.6%, which supports the feasibility of home sampling for therapeutic drug monitoring.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.
A systematic review found mixed economic evidence for microsampling in therapeutic drug monitoring; one study reported no cost reduction with DBS home-sampling, €688 versus €676, whilst another predicted savings up to 61%. The authors caution that more work is required to assess costs alongside clinical outcomes and optimise logistics for decentralised implementation.
A study of 292 patients found that the slopes of home-collected stimulated dried blood spot C-peptide levels over six months predicted 12-month venous mixed-meal tolerance test results, P<0.001. This shows decentralised microsampling can monitor beta-cell function, though further validation is required to confirm its reliability and broader applicability.
Dried blood spot sampling matched venous serum performance for islet autoantibody detection and was considered minimally invasive and convenient by parents and stakeholders, supporting its use for decentralised screening in home or community settings.