Citations 2
Establishing Reference Values in Healthy Participants for the Cardiac Troponin T High-Sensitivity Gen 6 Assay: REF-TSIX Global Reference Study
Daniels, Lori B. , Mueller, Christian, Giannitsis, Evangelos, Meex, Steven J. R., Buehlmann, David, Dilba, Peter, Bendig, Garnet, Cole, Mette, Body, Richard, Christenson, Robert H, deFilippi, Christopher R, Inoue, Kenji, Jaffe, A S, McCarthy, Cian P. , McCord, J., Neumann, Johannes T, Omland, T., Papendick, Cynthia , Sandoval, Yader, Twerenbold, Raphael, Peacock, W Frank, Mills, Nicholas L, investigators, the TSIX, Jacobs, Michael B., Lucksinger, Gregg, Powell, Richard, Johnson, Daniel, Coleman, Hugh, Fein, M, Surber, Joseph, Vu, Jack B., Hassman, Michael, Hernandez, John, Kirstein, Judith, Tomaszewski, Christian, Runyon, Michael S. , Gong, Jonathan , Wein, D., Andrabi, Sara , Kopin, David , Larrain, Germain, Tahirkheli, Naheem, Clemency, Brian, Abdullah, Shuaib, Hira, Ravi S. , Klausner, H A, Mahler, Simon A. , Crystal, Chad, Headden, Gary, Chaille, Peter, Cannon, Chad Aaron, Limkakeng, Alexander, Tolia, Vaishal , Knapp, Barry J., Massoomi, Mohammad, Sandoval, Yader, Ko, Emily, Luzzi, Verónica, Christenson, Robert, Carson, Jennifer Powers , Cacioppo, F , Kolev, E., Petrov, Andrey, Hazarbasanov, Dobri , Simova, lana, Magimaiseelan, Luci Suganthi, Kosch, Christine, Klein, G, Mehltretter, Kai, Sauter, Joachim, Baumann, Sybille, Moeckel, Martin, Twerenbold, Raphael, Muller-Hennessen, Matthias, Biener, Moritz , Findeisen, P., Omland, Torbjøm, Wilczek-Kosowska, Urszula, Zimmer-Satora, Ewa, Krecipro-Nizińska, Ewa, Miró, O, Díaz, Víctor Jiménez , Mueller, C, Christ, Michael, Lynch, Stephen, BODY, R. A. F., Matsuki, Shunji, Eto, Takashi, Tanaka, Takanori, Hanada, Ryuzo, Nakagami, Takuo, Nakama, T, Kadota, K., Jing, Shan, Yu, Shuwen, Zhang, Hongxuan, Zhang, Jun, Huo, Yong, Zhang, Yan, Yan, Li, Jiang, Longyuan, Chen, Weiqiang, Huang, Jianying, Zhao, Yan, Guan, Ling, Yang, Yanhua, Zhang, Qin, Qiu, Zhaohui, Body, Richard , Neumann, Franz–Josef , Müller, Christian , Mueller, Christian , Body, Rick , Eggers, Kai M. , Jaffe, Allan S. , Neumann, Johannes T , Sandoval, Yader , Tan, Jack Wei Chieh , Than, Martin , Twerenbold, Raphael , Mills, Nicholas L , Daniels, Lori B , Giannitsis, Evangelos , Meex, Steven J.R. , Christenson, Robert H. , Cobbaert, Christa M. , deFilippi, Christopher R. , McCord, James , Omland, Torbjørn , Sandoval, Yader , Tan, Jack Wei Chieh , Than, Martin , Twerenbold, Raphael , Surber, Joseph, Tomaszewski, Christian, Clemency, Brian, Headden, Gary , Cannon, Chad, Knapp, Barry , Tran, Nam K , Niederdöckl, Jan Daniel , Kolev, Emil, Popov, Todor, Sauter, Joachim, Baumann, Sybille , Möeckel, Martin , Müller‐Hennessen, Matthias, Findeisen, Peter, Scharnhorst, Volkher , Omland, T, Krecipro-Nizińska, Ewa, Christ, Michael , Nakagami, Takuo, Huo, Yong
Clinical Chemistry | January 18, 2026 | Volume: 72 | Issue: 4 | Pages: 488-502
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 range cohort. Methods Lithium-heparin plasma and serum samples were prospectively collected from apparently healthy individuals aged ≥20 years across 34 global sites in the United States, Europe, China, and Japan. cTnT was measured using the Troponin T high-sensitivity Gen 6 assay on the Cobas® e 801 analyzer. Exclusion criteria were defined according to the 2022 IFCC guidance. Uniform and sex-specific 99th percentile URLs and nonparametric 95% CIs were determined in plasma and serum separately and combined. Results The final study population comprised 4147 participants (52.5% female) with a median (25th–75th percentiles) age of 48.0 (33.0–59.0) years; 45.8%, 47.9%, 5.2%, and 1.1% were White, Asian, Black, and other/unknown, respectively. For sample matrices combined (n = 8294), 81.0% and 99.2% of cTnT values were above the limit of detection in females and males, respectively. Sex-specific 99th percentile URLs (95% CI) were 18 (16–23) ng/L for females and 32 (28–35) ng/L for males; the uniform 99th percentile URL was 27 (24–31) ng/L. URLs were comparable in plasma and serum samples. Conclusions This study determined sex-specific and uniform 99th percentile URLs for the Troponin T high-sensitivity Gen 6 assay that were comparable irrespective of the matrix used in a large, global, healthy reference population.
Ongoing and Focused Provider Performance Evaluations in Emergency Medicine: Current Practices and Modified Delphi to Guide Future Practice
Walker, Laura , Phelan, Michael , Bitner, Matthew , Legome, Eric , Tomaszewski, Christian, Strauss, Robert W., Nestler, David M. , Walker, Laura E
American Journal of Medical Quality | September 13, 2019 | Volume: 35 | Issue: 4 | Pages: 306-314
The Joint Commission requires ongoing and focused provider performance evaluations (OPPEs/FPPEs). The authors aim to describe current approaches in emergency medicine (EM) and identify consensus-based best practice recommendations. An online survey was distributed to leaders in EM to gain insight into current practices. A modified Delphi approach was then used to develop consensus to recommend best practice. A variety of strategies are currently in use for OPPE/FPPE. “Peer reviewed cases with opportunity for improvement” was identified as a preferred metric for OPPE. Although the preference was for use of peer review in OPPE, a consistent and standard adoption of robust internal care review processes is needed to establish expected norms. National benchmarking is not available currently. This was a limited survey of self-identified leaders, and there is an opportunity for additional engagement of leaders in EM to identify a unified approach that appropriately relates to patient outcomes.