Hoe zit het met standaardiseren van testen?

[Sproetje]

https://pubmed.ncbi.nlm.nih.gov/2183731/

Also, standards have not yet been developed for PCR testing and there is a risk of false-positive test results.
https://www.uofmhealth.org/health-library/hw5113

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The utility of serologic test results in arriving at a diagnosis is limited by the inherent deficiencies of the existing tests regarding sensitivity and specificity.
The lack of test standardization further complicates the interpretation of test results.
A proficiency testing program for Lyme disease serology conducted among 45 laboratories indicated a high rate of false-negative results and a considerable rate of false-positive results.1
Most alarming, however, was the variability of results, both among different laboratories and within a given laboratory.
The reproducibility of test results was poor


https://journals.sagepub.com/doi/pdf/10 ... 9600800209

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https://www.jhsph.edu/research/centers- ... esting.pdf

Educatie research centrum van Johns Hopkins instituut
J. Stephen Dumler, M.D.Division of Medical MicrobiologyDepartment of PathologyThe Johns Hopkins University School of Medicine:

Laboratory Diagnosis of Lyme disease


Serology
Enzyme immunoassay (EIA) methods
very sensitive, limited specificity (false positives)
whole bacterial cell lysates or individual recombinant proteins
generally not immunoglobulin class specific

Western blot assays to aid specificity
supplemental method for EIA positives requires presence of specific antigen bands on IgM or IgG immunoblots

Pitfalls in serologic diagnosis
lack of early response
abrogation by early Rx
persistent antibody in absence of active disease
lack of standardization
no FDA-cleared test for detection of CSF antibodies


Wormser zegt het ook:

One of the limitations of ELISA for detection of B. burgdorferi sensu lato antibodies is lack of standardization. Variations exist between assays in terms of antigenic composition
and in the detection of specific immunoglobulin classes, particularly in the detection of IgM antibodies (7, 8, 34, 167, 337)

https://www.aldf.com/wp-content/uploads ... enfeld.pdf

[Sproetje]

https://pubmed.ncbi.nlm.nih.gov/24750682/

[.....]
. Despite efforts so far, standardization is not reached yet, but progress has been made. On-going efforts to reduce the interlaboratory/interassay variations remain important; even an absolute standardization cannot be feasibly achieved.
[....]

Er is nu al meer dan 20 jaar in onderzoek hoe toch de antistoffen testen te standaardiseren, maar tot nu toe is het nog steeds niet gelukt

[Sproetje]

Moet er wel bijzeggen dat de laatste link een inzage geeft over de problemen met de antistoffen testen voor bloedproppen, maar ook daar problemen.

Behoorlijk vervelend voor ons is dat de antistoffentesten voor lyme nu juist bij de IgM zo enorm verschillen.
En in Apeldoorn werd ik niet behandeld omdat juist de IgM net niet hoog genoeg was.
Die zou ik dan nodig hebben gehad om een actieve infectie te kunnen aantonen.