Clinical Chemistry

Detection of Advanced Liver Fibrosis Using Blood Noninvasive Tests: A Laboratory Medicine Perspective

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Clin Chem. 2026 Feb 3:hvaf193. doi: 10.1093/clinchem/hvaf193. Online ahead of print. ABSTRACT BACKGROUND: Despite its growing impact, advanced liver fibrosis (ALF) remains substantially underdiagnosed in both primary and specialized care settings. Since liver cirrhosis is typically preceded by a prolonged phase of asymptomatic fibrosis, early detection of ALF, particularly in high-risk individuals, represents a public … Read more

Discovery of an Artificial Intelligence Label Feedback Loop: How the Success of a Clinically Implemented Artificial Intelligence Algorithm Has Created an Unforeseen Challenge to Algorithm Retraining

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Clin Chem. 2026 Feb 2:hvag001. doi: 10.1093/clinchem/hvag001. Online ahead of print. ABSTRACT BACKGROUND: Artificial intelligence (AI) augmented laboratory tests can improve quality, efficiency, cost-effectiveness, and staff satisfaction. However, the clinical success of these tests can introduce unforeseen challenges for model retraining. This study describes the discovery of an “AI label feedback loop” in a clinically … Read more

PIDgeon: An Explainable AI Model for Improved Flow Cytometry-Based Screening of Lymphoid Primary Immunodeficiencies

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Clin Chem. 2026 Jan 29:hvaf190. doi: 10.1093/clinchem/hvaf190. Online ahead of print. ABSTRACT BACKGROUND: Primary immunodeficiencies (PIDs) are rare disorders caused by immune system defects that are commonly screened using multi-parameter flow cytometry (FCM). To counter the subjective and time-consuming manual data analysis of FCM data, we present PIDgeon, a fully automated computational pipeline based on … Read more

Disseminated Coccidioidomycosis in Immunocompetent Hosts: Opportunities for Increased Recognition and Timely Diagnosis

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Clin Chem. 2026 Jan 28:hvaf187. doi: 10.1093/clinchem/hvaf187. Online ahead of print. ABSTRACT BACKGROUND: While most pulmonary infections with Coccidioides spp. are self-limited, a subset of patients is at higher risk for severe disease and extrapulmonary dissemination, including individuals with certain ethnic backgrounds. Disseminated disease can involve soft tissues, bones, and the central nervous system with … Read more

Evaluation of a New Antibody-Based NT-proBNP Assay for Acute Dyspnea in the Emergency Department

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Clin Chem. 2026 Jan 28:hvaf168. doi: 10.1093/clinchem/hvaf168. Online ahead of print. ABSTRACT BACKGROUND: Diagnosis and risk stratification of acute heart failure (HF) in the emergency department (ED) remains challenging. N-terminal pro-B type natriuretic peptide (NT-proBNP) measurement is useful in evaluating acute dyspnea. The objective of this study was to evaluate the diagnostic performance of a … Read more

Real-Time Reverse Transcription Quantitative PCR (RT-qPCR) Methodological Standards and Reporting Practices

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Clin Chem. 2026 Jan 28:hvaf176. doi: 10.1093/clinchem/hvaf176. Online ahead of print. ABSTRACT BACKGROUND: Real-time reverse transcription quantitative PCR (RT-qPCR) is utilized in many areas of the life sciences, diagnostics, and forensics, yet concerns about methodological quality and reporting transparency persist. Diagnostic testing during the recent pandemic brought those concerns into the public domain. The Minimum … Read more

Establishing Reference Values in Healthy Participants for the Cardiac Troponin T High-Sensitivity Gen 6 Assay: REF-TSIX Global Reference Study

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Clin Chem. 2026 Jan 21:hvag011. doi: 10.1093/clinchem/hvag011. Online ahead of print. ABSTRACT BACKGROUND: Measurement of cardiac troponin (cTn) using high-sensitivity assays is recommended for the diagnosis of myocardial infarction. We determined sex-specific and uniform 99th percentile upper reference limits (URLs) using the new Elecsys® Troponin T high-sensitivity Gen 6 assay in a global, healthy reference … Read more

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