Use of inductively coupled plasma mass spectrometry to measure urinary iodine in NHANES 2000: comparison with previous method.

ambulance or jet during actual transport. Although this " before transport " portion of testing may impact overall transport costs by altering transport time, it remains a topic for future utilization review. One concern with POCT in critical care transport is the potential for excessive utilization because of the availability and ease of testing. A primary finding of this study was the low rate of utilization. Although POCT equipment was available for all transports over the 6 years, testing was performed in only 17% of cases. Rates were higher in patients with high acuity than for patients with more stable conditions. The annual rate of use was relatively constant, and rampant overuse of laboratory testing in this environment clearly did not occur for this testing program. In many clinical settings, POCT has been reported to improve patient care (7–12). One of the most controversial aspects of POCT is the cost (7, 8, 10, 11). In the intensive care unit, it may not be cost-effective to use POCT when a substantially less expensive central laboratory test is available. In the transport setting, the issue is the cost of POCT vs no testing at all. We found that POCT represents a very small fraction of overall transport costs and a relatively small cost per case considering the potential for significant clinical benefit. POCT has a unique niche in critical care transport, and our experience shows that testing can be performed with high reliability. POCT provides the benefit of rapid analysis of critical analytes and blood gases in a setting where no other laboratory analysis is available. POCT in the transport setting is infrequent and is relatively inexpensive. This study demonstrated that the use of POCT led to changes in patient treatment 30% of the times when testing was performed. We would like to thank Carol Howard for sharing her insight and experience with POCT in preparation of this manuscript. care implications of a hand-held whole blood analyzer in the prehospital setting. Urinary iodine (UI) concentrations directly reflect dietary iodine intake and consequently test biochemical assessment of the iodine status worldwide (1). measured the UI content of specimens as part of the National Health and Nutrition Examination Survey (NHANES) 2000 and will measure UI in the US population through future NHANES analyses, using inductively coupled plasma mass spectrometry (ICP-MS). In this report, we describe the ICP-MS laboratory method and compare that method with …