Influence of automation on Aβ1-42/Aβ1-40 ratio and its use

Previous posts in this series:

• Use of the Aβ1-42/Aβ1-40 ratio to improve accuracy of AD diagnosis
• Aβ1-42/Aβ1-40 ratio for interpretation of discordant results
• Improvement of AD risk scores by use of the Aβ1-42/Aβ1-40 ratio
• How to work with Aβ1-42/Aβ1-40 ratio
• Comparison of Aβ1-42/Aβ1-40 ratio with other ratios

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• Automation is an important step in the direction of more standardization.
• With the use of automated systems, economic considerations and lab organization could lead to a simultaneous analysis of Aβ1-42 and Aβ1-40 or the ratio as reflex test for the routine clinical practice.
• Automation offers a higher level of standardization combining multiple parameters in comparison to manual testing.

Automation is an important step in the direction of more standardization as it limits the number of manual handling steps and therefore minimizes handling modifications from IFU instructions and the risk of mistakes due to manual manipulations of the samples or the assay.

As it is generally seen as important to evaluate both parameters in the same run, the development of an automated system that allows testing of both Aβ1-42 and Aβ1-40 in parallel and eliminates not only manual interactions but also run-to-run variability. This capability represents a big step towards standardization. Automation of the analysis of Aβ1-42 and Aβ1-40 with individual test results and the possibility of a ratio calculation as automated output could improve and simplify the use of the ratio and would most probably allow more clinicians to use this tool to normalise their Aβ1-42 results.

In addition, false positives or other mistakes can be observed due to complex preanalytical conditions. If an automated system is used it could be – due to economical consideration and lab organization - easier to test Aβ1-42 and Aβ1-40 simultaneously and in routine. This would even further increase the level of reliability of the results as it combines the higher level of standardization (less manual interaction, standardized protocol, etc.) linked to automated testing with a higher degree of reliability of the Aβ1-42/Aβ1-40 ratio in comparison with one parameter alone.

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