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Sensitivity, Accuracy, and Analytic Testing

In some circumstances, the sensitivity and accuracy of an analysis are reduced or increased as functions of clinical purpose. For example, ion exchange chromatography of plasma amino acids for the diagnosis of inborn errors of metabolism is usually performed at an analytic sensitivity that allows measurement of all of the amino acids with a single set of standards. The range of values is approximately 20-800 ?mol/L, and accuracy is poor at values of ≤20 ?mol/L. The detection of homocysteine in this type of analysis suggests an inborn error of methionine metabolism. If the analysis is adjusted to achieve greater analytic sensitivity, it is possible to measure homocysteine accurately in normal plasma (3-12 ?mol/L). This more sensitive test is used to assess cobalamin status and analyze risk factors for atherosclerotic cardiovascular disease.

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