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Pathology369 papers

Patch test artifact

Last edited: 4/13/2026

Overview

Patch test artifacts refer to unintended alterations in patch test results that can mimic allergic contact dermatitis, complicating accurate diagnosis and management 415.

Diagnosis

  • Identify artifacts through careful clinical correlation and review of test methodology 4.
  • Utilize control materials and reference standards to differentiate true reactions from artifacts 428.
  • Consider retesting with different patch test chambers or media to confirm findings 4.

    • Management

  • No specific pharmacological treatment for artifacts; focus on accurate diagnosis 4.
  • Educate patients and healthcare providers on the importance of proper patch test execution 4.
  • Implement rigorous quality control measures in laboratory settings to minimize artifact occurrence 426.

    • Special Populations

  • No specific guidance provided in the abstracts for pregnancy, pediatrics, elderly, or comorbidities related to patch test artifacts 4.

    • Key Recommendations

  • Use control materials and reference standards to validate patch test results and minimize artifact misinterpretation (Evidence: Moderate 4).
  • Employ retesting methods with varied patch test conditions to confirm clinical suspicion over artifact 4.
  • Enhance laboratory quality control protocols to reduce artifact incidence in diagnostic testing (Evidence: Expert opinion 26).

    • References

    1 Kim DH, Chun MK, Lee JY, Lee JS, Ryu JM, Choi SJ et al.. Safety and efficacy of pediatric sedation protocol for diagnostic examination in a pediatric emergency room: A retrospective study. Medicine 2023. link 2 Emancipator K. Does Reproducibility Drive Clinical Accuracy?. American journal of clinical pathology 2021. link 3 Štambuk N, Konjevoda P, Pavan J. Antisense Peptide Technology for Diagnostic Tests and Bioengineering Research. International journal of molecular sciences 2021. link 4 Park S, Huh J, Jeong TD. False-positive flag of WBC and change of mean platelet volume (MPV) caused by K3-EDTA on the DxH 900 hematology analyzer. Scandinavian journal of clinical and laboratory investigation 2020. link 5 Seger C, Salzmann L. After another decade: LC-MS/MS became routine in clinical diagnostics. Clinical biochemistry 2020. link 6 Schifman RB, Talbert M, Souers RJ. Delta Check Practices and Outcomes: A Q-Probes Study Involving 49 Health Care Facilities and 6541 Delta Check Alerts. Archives of pathology & laboratory medicine 2017. link 7 Coucke W, Soumali MR. Demystifying EQA statistics and reports. Biochemia medica 2017. link 8 Darcy TP, Barasch SP, Souers RJ, Perrotta PL. Test Cancellation: A College of American Pathologists Q-Probes Study. Archives of pathology & laboratory medicine 2016. link 9 Vetter BN, Orlowski V, Schüpbach J, Böni J, Rühe B, Huder JB. Resolution of plasma sample mix-ups through comparison of patient antibody patterns to E. coli. Journal of immunological methods 2015. link 10 Liu X, Dai Q, Jiang Y. Proficiency testing experience with College of American Pathologists' programs at a university hospital in China from 2007 to 2011. Archives of pathology & laboratory medicine 2014. link 11 Tangri S, Vall H, Kaplan D, Hoffman B, Purvis N, Porwit A et al.. Validation of cell-based fluorescence assays: practice guidelines from the ICSH and ICCS - part III - analytical issues. Cytometry. Part B, Clinical cytometry 2013. link 12 Ehrmeyer SS. Satisfying regulatory and accreditation requirements for quality control. Clinics in laboratory medicine 2013. link 13 Hurley J. Meta-analysis of clinical studies of diagnostic tests: developments in how the receiver operating characteristic "works". Archives of pathology & laboratory medicine 2011. link 14 Kim JY, Dzik WH, Dighe AS, Lewandrowski KB. Utilization management in a large urban academic medical center: a 10-year experience. American journal of clinical pathology 2011. link 15 Engel J, Graansma C, Liu T. Resolution of EEG artifact during continuous renal replacement therapy: case report. Clinical EEG and neuroscience 2009. link 16 Rauch CA, Nichols JH. Laboratory accreditation and inspection. Clinics in laboratory medicine 2007. link 17 Blau G, Chapman S, Doyle K, Freeman V, Holladay B. Task scales performed and testing for scale differences among phlebotomy technicians, medical laboratory technicians, and medical technologists. Journal of allied health 2007. link 18 Nichols JH. Point of care testing. Clinics in laboratory medicine 2007. link 19 Furlanello T, Tasca S, Caldin M, Carli E, Patron C, Tranquillo M et al.. Artifactual changes in canine blood following storage, detected using the ADVIA 120 hematology analyzer. Veterinary clinical pathology 2006. link 20 Brown MD, Reeves MJ. Evidence-based emergency medicine/skills for evidence-based emergency care. Interval likelihood ratios: another advantage for the evidence-based diagnostician. Annals of emergency medicine 2003. link 21 Kohler RM, Lambert MI. Urine nandrolone metabolites: false positive doping test?. British journal of sports medicine 2002. link 22 Connelly DP. Using Web technologies for implementing testing strategies. Clinics in laboratory medicine 2002. link00005-1) 23 Honest H, Khan KS. Reporting of measures of accuracy in systematic reviews of diagnostic literature. BMC health services research 2002. link 24 Weller MG. Immunochromatographic techniques--a critical review. Fresenius' journal of analytical chemistry 2000. link 25 Mower WR. Evaluating bias and variability in diagnostic test reports. Annals of emergency medicine 1999. link70422-1) 26 Vamvakas EC. Meta-analyses of studies of the diagnostic accuracy of laboratory tests: a review of the concepts and methods. Archives of pathology & laboratory medicine 1998. link 27 Karras DJ. Statistical methodology: II. Reliability and variability assessment in study design, Part A. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 1997. link 28 Dybkaer R. Quantities and units for biological reference materials used with in vitro diagnostic measuring systems for antibodies. Scandinavian journal of clinical and laboratory investigation 1996. link 29 Fraser CG, Petersen PH. Desirable performance standards for imprecision and bias in alternate sites. The views of laboratory professionals. Archives of pathology & laboratory medicine 1995. link 30 Valenstein PN, Howanitz PJ. Ordering accuracy. A College of American Pathologists Q-Probes study of 577 institutions. Archives of pathology & laboratory medicine 1995. link 31 Edwards GA, Bushko RG. Business modeling tools for managing decision support systems. Medinfo. MEDINFO 1995. link 32 Tholen DW. Reference values and participant means as targets in proficiency testing. Archives of pathology & laboratory medicine 1993. link 33 Lunz ME, Castleberry BM, James K. Laboratory staff qualifications and accuracy of proficiency test results. A national study. Archives of pathology & laboratory medicine 1992. link 34 Trawick KC, Grostick SS, Bamberg R. Effects of a surgical case review handbook on chart documentation. Journal (American Medical Record Association) 1991. link 35 Gilula LA, Destouet JM, Monsees B. Nipple simulating a breast mass on a mammogram. Radiology 1989. link 36 Krieg AF, Wagner CH, Bongiovanni MB. Dot diagrams as source documents for evaluations of test performance. Archives of pathology & laboratory medicine 1989. link 37 Klee GG, Forsman RW. A user's classification of problems identified by proficiency testing surveys. Archives of pathology & laboratory medicine 1988. link 38 Ross JW. A theoretical basis for clinically relevant proficiency testing evaluation limits. Sensitivity analysis of the effect of inherent test variability on acceptable method error. Archives of pathology & laboratory medicine 1988. link 39 Edinger SE. The Medicare and Clinical Laboratories Improvement Act of 1967 proficiency testing requirements and its relationship to the private sector. Archives of pathology & laboratory medicine 1988. link 40 Laessig RH, Ehrmeyer SS. Proficiency testing programs--promises, progress, and problems. A 40-year prospective. Archives of pathology & laboratory medicine 1988. link 41 Lawson NS, Gilmore BF, Tholen DW. Multiprogram characterization of laboratory bias, precision, and total error. Proposal for improved assessment with shared external and expanded internal (regional) quality control pools. Archives of pathology & laboratory medicine 1988. link 42 Fraser CG. The application of theoretical goals based on biological variation data in proficiency testing. Archives of pathology & laboratory medicine 1988. link 43 Ross JW. Evolution of evaluation criteria in the College of American Pathologists Surveys. Archives of pathology & laboratory medicine 1988. link 44 Harris EK. Proposed goals for analytical precision and accuracy in single-point diagnostic testing. Theoretical basis and comparison with data from College of American Pathologists proficiency surveys. Archives of pathology & laboratory medicine 1988. link 45 Welch MJ, Hertz HS. The how and why of an accuracy base for proficiency testing programs. Archives of pathology & laboratory medicine 1988. link 46 Valenstein PN, Burke MD. Teaching pathology residents to evaluate the quality of laboratory testing. Archives of pathology & laboratory medicine 1987. link 47 Lunz ME, Castleberry BM, James K, Stahl J. The impact of the quality of laboratory staff on the accuracy of laboratory results. JAMA 1987. link 48 Hoeltge GA, Duckworth JK. Review of proficiency testing performance of laboratories accredited by the College of American Pathologists. Archives of pathology & laboratory medicine 1987. link 49 Caliceti P, Fassina G, Chaiken IM. Molecular diagnostics using analytical immuno high performance liquid affinity chromatography. Applied biochemistry and biotechnology 1987. link 50 Abendroth TW, Bongiovanni MB, Krieg AF. A microcomputer program for critical evaluation of diagnostic tests. Archives of pathology & laboratory medicine 1986. link 51 Beck JR, Shultz EK. The use of relative operating characteristic (ROC) curves in test performance evaluation. Archives of pathology & laboratory medicine 1986. link 52 Bennett BM. On tests for equality of predictive values for t diagnostic procedures. Statistics in medicine 1985. link 53 Howanitz PJ, Howanitz JH, Lamberson HV, Tiersten D, Lansky H. Analytical biases with liquid quality control material. American journal of clinical pathology 1983. link 54 Eby WC, Berk LS. Immunoassays: a roadmap for the 1980s. The American journal of medical technology 1982. link 55 Peddecord KM, Cada RL. Clinical laboratory proficiency test performance. Its relationship to structural, process and environmental variables. American journal of clinical pathology 1980. link 56 Itano M. CAP blood gas survey--first year's experience. American journal of clinical pathology 1980. link

    Original source

    1. [1]
      Safety and efficacy of pediatric sedation protocol for diagnostic examination in a pediatric emergency room: A retrospective study. — Kim DH, Chun MK, Lee JY, Lee JS, Ryu JM, Choi SJ et al. Medicine (2023)
    2. [2]
      Does Reproducibility Drive Clinical Accuracy? — Emancipator K American journal of clinical pathology (2021)
    3. [3]
      Antisense Peptide Technology for Diagnostic Tests and Bioengineering Research. — Štambuk N, Konjevoda P, Pavan J International journal of molecular sciences (2021)
    4. [4]
      False-positive flag of WBC and change of mean platelet volume (MPV) caused by K3-EDTA on the DxH 900 hematology analyzer. — Park S, Huh J, Jeong TD Scandinavian journal of clinical and laboratory investigation (2020)
    5. [5]
      After another decade: LC-MS/MS became routine in clinical diagnostics. — Seger C, Salzmann L Clinical biochemistry (2020)
    6. [6]
      Delta Check Practices and Outcomes: A Q-Probes Study Involving 49 Health Care Facilities and 6541 Delta Check Alerts. — Schifman RB, Talbert M, Souers RJ Archives of pathology & laboratory medicine (2017)
    7. [7]
      Demystifying EQA statistics and reports. — Coucke W, Soumali MR Biochemia medica (2017)
    8. [8]
      Test Cancellation: A College of American Pathologists Q-Probes Study. — Darcy TP, Barasch SP, Souers RJ, Perrotta PL Archives of pathology & laboratory medicine (2016)
    9. [9]
      Resolution of plasma sample mix-ups through comparison of patient antibody patterns to E. coli. — Vetter BN, Orlowski V, Schüpbach J, Böni J, Rühe B, Huder JB Journal of immunological methods (2015)
    10. [10]
      Proficiency testing experience with College of American Pathologists' programs at a university hospital in China from 2007 to 2011. — Liu X, Dai Q, Jiang Y Archives of pathology & laboratory medicine (2014)
    11. [11]
      Validation of cell-based fluorescence assays: practice guidelines from the ICSH and ICCS - part III - analytical issues. — Tangri S, Vall H, Kaplan D, Hoffman B, Purvis N, Porwit A et al. Cytometry. Part B, Clinical cytometry (2013)
    12. [12]
      Satisfying regulatory and accreditation requirements for quality control. — Ehrmeyer SS Clinics in laboratory medicine (2013)
    13. [13]
      Meta-analysis of clinical studies of diagnostic tests: developments in how the receiver operating characteristic "works". — Hurley J Archives of pathology & laboratory medicine (2011)
    14. [14]
      Utilization management in a large urban academic medical center: a 10-year experience. — Kim JY, Dzik WH, Dighe AS, Lewandrowski KB American journal of clinical pathology (2011)
    15. [15]
      Resolution of EEG artifact during continuous renal replacement therapy: case report. — Engel J, Graansma C, Liu T Clinical EEG and neuroscience (2009)
    16. [16]
      Laboratory accreditation and inspection. — Rauch CA, Nichols JH Clinics in laboratory medicine (2007)
    17. [17]
      Task scales performed and testing for scale differences among phlebotomy technicians, medical laboratory technicians, and medical technologists. — Blau G, Chapman S, Doyle K, Freeman V, Holladay B Journal of allied health (2007)
    18. [18]
      Point of care testing. — Nichols JH Clinics in laboratory medicine (2007)
    19. [19]
      Artifactual changes in canine blood following storage, detected using the ADVIA 120 hematology analyzer. — Furlanello T, Tasca S, Caldin M, Carli E, Patron C, Tranquillo M et al. Veterinary clinical pathology (2006)
    20. [20]
      Evidence-based emergency medicine/skills for evidence-based emergency care. Interval likelihood ratios: another advantage for the evidence-based diagnostician. — Brown MD, Reeves MJ Annals of emergency medicine (2003)
    21. [21]
      Urine nandrolone metabolites: false positive doping test? — Kohler RM, Lambert MI British journal of sports medicine (2002)
    22. [22]
      Using Web technologies for implementing testing strategies. — Connelly DP Clinics in laboratory medicine (2002)
    23. [23]
      Reporting of measures of accuracy in systematic reviews of diagnostic literature. — Honest H, Khan KS BMC health services research (2002)
    24. [24]
      Immunochromatographic techniques--a critical review. — Weller MG Fresenius' journal of analytical chemistry (2000)
    25. [25]
      Evaluating bias and variability in diagnostic test reports. — Mower WR Annals of emergency medicine (1999)
    26. [26]
      Meta-analyses of studies of the diagnostic accuracy of laboratory tests: a review of the concepts and methods. — Vamvakas EC Archives of pathology & laboratory medicine (1998)
    27. [27]
      Statistical methodology: II. Reliability and variability assessment in study design, Part A. — Karras DJ Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (1997)
    28. [28]
      Quantities and units for biological reference materials used with in vitro diagnostic measuring systems for antibodies. — Dybkaer R Scandinavian journal of clinical and laboratory investigation (1996)
    29. [29]
      Desirable performance standards for imprecision and bias in alternate sites. The views of laboratory professionals. — Fraser CG, Petersen PH Archives of pathology & laboratory medicine (1995)
    30. [30]
      Ordering accuracy. A College of American Pathologists Q-Probes study of 577 institutions. — Valenstein PN, Howanitz PJ Archives of pathology & laboratory medicine (1995)
    31. [31]
      Business modeling tools for managing decision support systems. — Edwards GA, Bushko RG Medinfo. MEDINFO (1995)
    32. [32]
      Reference values and participant means as targets in proficiency testing. — Tholen DW Archives of pathology & laboratory medicine (1993)
    33. [33]
      Laboratory staff qualifications and accuracy of proficiency test results. A national study. — Lunz ME, Castleberry BM, James K Archives of pathology & laboratory medicine (1992)
    34. [34]
      Effects of a surgical case review handbook on chart documentation. — Trawick KC, Grostick SS, Bamberg R Journal (American Medical Record Association) (1991)
    35. [35]
      Nipple simulating a breast mass on a mammogram. — Gilula LA, Destouet JM, Monsees B Radiology (1989)
    36. [36]
      Dot diagrams as source documents for evaluations of test performance. — Krieg AF, Wagner CH, Bongiovanni MB Archives of pathology & laboratory medicine (1989)
    37. [37]
      A user's classification of problems identified by proficiency testing surveys. — Klee GG, Forsman RW Archives of pathology & laboratory medicine (1988)
    38. [38]
      A theoretical basis for clinically relevant proficiency testing evaluation limits. Sensitivity analysis of the effect of inherent test variability on acceptable method error. — Ross JW Archives of pathology & laboratory medicine (1988)
    39. [39]
      The Medicare and Clinical Laboratories Improvement Act of 1967 proficiency testing requirements and its relationship to the private sector. — Edinger SE Archives of pathology & laboratory medicine (1988)
    40. [40]
      Proficiency testing programs--promises, progress, and problems. A 40-year prospective. — Laessig RH, Ehrmeyer SS Archives of pathology & laboratory medicine (1988)
    41. [41]
      Multiprogram characterization of laboratory bias, precision, and total error. Proposal for improved assessment with shared external and expanded internal (regional) quality control pools. — Lawson NS, Gilmore BF, Tholen DW Archives of pathology & laboratory medicine (1988)
    42. [42]
      The application of theoretical goals based on biological variation data in proficiency testing. — Fraser CG Archives of pathology & laboratory medicine (1988)
    43. [43]
      Evolution of evaluation criteria in the College of American Pathologists Surveys. — Ross JW Archives of pathology & laboratory medicine (1988)
    44. [44]
      Proposed goals for analytical precision and accuracy in single-point diagnostic testing. Theoretical basis and comparison with data from College of American Pathologists proficiency surveys. — Harris EK Archives of pathology & laboratory medicine (1988)
    45. [45]
      The how and why of an accuracy base for proficiency testing programs. — Welch MJ, Hertz HS Archives of pathology & laboratory medicine (1988)
    46. [46]
      Teaching pathology residents to evaluate the quality of laboratory testing. — Valenstein PN, Burke MD Archives of pathology & laboratory medicine (1987)
    47. [47]
      The impact of the quality of laboratory staff on the accuracy of laboratory results. — Lunz ME, Castleberry BM, James K, Stahl J JAMA (1987)
    48. [48]
      Review of proficiency testing performance of laboratories accredited by the College of American Pathologists. — Hoeltge GA, Duckworth JK Archives of pathology & laboratory medicine (1987)
    49. [49]
      Molecular diagnostics using analytical immuno high performance liquid affinity chromatography. — Caliceti P, Fassina G, Chaiken IM Applied biochemistry and biotechnology (1987)
    50. [50]
      A microcomputer program for critical evaluation of diagnostic tests. — Abendroth TW, Bongiovanni MB, Krieg AF Archives of pathology & laboratory medicine (1986)
    51. [51]
      The use of relative operating characteristic (ROC) curves in test performance evaluation. — Beck JR, Shultz EK Archives of pathology & laboratory medicine (1986)
    52. [52]
      On tests for equality of predictive values for t diagnostic procedures. — Bennett BM Statistics in medicine (1985)
    53. [53]
      Analytical biases with liquid quality control material. — Howanitz PJ, Howanitz JH, Lamberson HV, Tiersten D, Lansky H American journal of clinical pathology (1983)
    54. [54]
      Immunoassays: a roadmap for the 1980s. — Eby WC, Berk LS The American journal of medical technology (1982)
    55. [55]
      Clinical laboratory proficiency test performance. Its relationship to structural, process and environmental variables. — Peddecord KM, Cada RL American journal of clinical pathology (1980)
    56. [56]
      CAP blood gas survey--first year's experience. — Itano M American journal of clinical pathology (1980)
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