Samlet viser MTV-rapporten, at selvom for–
udsa:tningerne for at
indf~re
MMA som diag–
nostisk
mark~r
for vitaminB-12mangel analy–
seteknisk var meget gode, er vores viden om
den kliniske anvendelse af testen mangelfuld.
Det er vanskeligt at
opg~re
de samlede omkost–
ninger ved udredning for vitamin B-12 mangel,
men det er åbenlyst, at vi siden introduktionen
af MMA har set et
~get
ressourceforbrug til
både diagnostik og behandling af vitamin B-12
mangel. Achillesha:len er, at vi endnu ikke ken–
der sundhedsgevisten ved dette
~gede
ressour–
ceforbrug. I den fremtidige forskning er der
sa:rligt behov for at afklare hvilke patienter, der
på la:ngere sigt har gavn af vitamin B-12
behandling.
(l)
Hvas AM, Vestergaard H, Gerdes LU,
N
ex~
E.
Physicians ' use
of plasma
methylmalonic acid as a diagnostic tool. J
Intern Med 2000; 247:311-317.
(2) Hvas AM, Lous J, Ellegaard J,
Nex~
E.
Use of plasma methylmalonic acid for
diagnosis of vitamin B-12 deficiency in
general practice. Submitted 2001.
(3) Hvas AM, Juul S, Gerdes LU,
Nex~
E.
The marker of cobalamin deficiency,
plasma methylmalonic acid, correlates to
plasma creatinine. J Intern Med 2000;
247:507-512.
(4) Hvas AM, Ellegaard J,
Nex~
E. Increased
plasma methylmalonic acid does not pre–
diet clinical manifestations of vitamin B-
12 deficiency. Arch Intern Med 2001;
161:1534-1541.
(5) Hvas AM, Ellegaard J,
Nex~
E. Vitamin
B-12 treatment normalizes metabolic mar–
kers but has limited clinical effect: A ran–
domized placebo-controHed study. Clin
Chem 2001; 47 :1396-1404.
(6) Hvas AM, Juul S,
Nex~
E, Ellegaard
J.
Vitamin B-12 treatment has limited effect
on health related quality of life among
individuals with elevated plasma methyl–
malonic acid: A randornized placebo-con–
trolied study. Submitted 2001.
Klinisk Kjemi
i
Norden 3, 2001
Diagnostisk osäkerhet och mätosäkerhet
Forts.fra side 14
many contexts? Accred QualAssur 1999;4:273.
De
Bievre P, Kaarls R, Peiser HS, Rasberry SD,
Reed WP. Protocols for traceability
in
chemical
analysis. Part I: Definitions and terminology.
Accred QualAssur 1997;2: 168-179.
Dybkaer R. From total allowable error via metrolo–
gical traceability to uncertainty of measurement of
the unbiased result. Accred QualAssur 1999;4:401-
405.
Dybkaer
R.
Metrology in laboratory medicine -
reference measurement systems. Accred Qual
Assur 2001 ;6:16-19.
Dybkaer R. TerminologicaJ problems around
«accuracy» and «uncertainty». Scand J Clin Lab
Invest 1998;58:35-46.
Dybkaer R. From total allowable error via metrolo–
gical traceability to uncertainty of measurement of
the unbiased result. Accred QualAssur 1999;4:401-
405.
EURACHEM/CITAC Guide, Quantifying Uncer–
tainty
in
Analytical Measurement Second Edition,
Final Draft: April 2000, Prepared by the EURA–
CHEM Measurement Uncertainty Working Group
in collaboration with members of CITAC , IAEA
and AOAC International
Jansen RTP. The quest for comparability: Calibra–
tion 2000. Accred QualAssur 2000;5:363-366.
Jansen RTP. The European way to go: Virtual cen–
trallaboratory. Accred QualAssur 1999;4:397-400.
Plebani M. and Carraro
P.
(1997) Mistakes in a stat
laboratory: types and frequency. Clin Chem 43,
1348-1351.
Ricos
C.
Alvarez
V.
Cava
F.
Garcia-Lario J
V.
Her–
nandez A. Jimenez C
V.
Minchinela
J.
Perich C.
Simon M. Current databases on biological varia–
tion: pros, eons and progress. Scand.
J.
Clin. Lab.
Invest. 1999;59:585.
Ross J W, Boone D J (1989) In: Martin
L,
Wagner
W, Essien JDK (eds.) Institute of critical issues in
health laboratory practice. DuPont Minneapolis,
Minn.,
p
92
Williams
A.
Introduction to measurement uncer–
tainty in chemical analysis. Accred Qual Assur
1998;3:92-4.
Williams A. What can we leam from traceability in
physical measurements? Accred Qual Assur
2000;5 :414-417.
29
