{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T14:47:59Z","timestamp":1791038879701,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Intraoperative parathyroid hormone (PTH) monitoring is a proven and reliable adjunct to parathyroid surgery, able to improve the outcomes and efficiency of the diagnostic and therapeutic pathway for patients with primary hyperparathyroidism. This study evaluated the innovative, compact, fully automated NBCL CONNECT Analyzer, which can measure whole-blood PTH in 5\u2005min.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective multicentre study was conducted in stages: results reviews, recommendations, and implementation of improvements to the mechanical design, components of cartridges, calibration, and sampling protocols. Patients undergoing parathyroidectomy had PTH levels measured on the Analyzer and main laboratory platforms, either Roche or Abbott. The Miami criterion of a 50% drop in PTH concentration was used to define biochemical cure during surgery, and normal postoperative calcium level as cure of primary hyperparathyroidism. Measurements on the Analyzer were done by laboratory staff in London and nurses in Stuttgart. The Pearson coefficient (R) and Wilcoxon test were used for statistical analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 234 patients (55 male, 179 female) with a median age of 58.5 (age full range 15\u201388) years underwent parathyroidectomy (195 minimally invasive, 38 bilateral neck exploration, 1 thoracoscopic; 12 conversions) for primary hyperparathyroidism between November 2021 and July 2022. Primary hyperparathyroidism was cured in 225 patients (96.2%). The sensitivity, specificity, and overall accuracy of the Analyzer assay in predicting biochemical cure were 83.9, 100, and 84.8% in phase 1; 91.2, 100, and 91.3% in phase 2; and 98.6, 100, and 98.6% in phase 3. There were no false-positive results (positive predictive value 100%). Correlations between Analyzer measurements and those obtained using the Roche device were very strong (R = 0.98, P &amp;lt; 0.001 in phase 1; R = 0.92, P &amp;lt; 0.001 in phase 2; R = 0.94, P &amp;lt; 0.001 in phase 3), and correlations for Analyzer readings versus those from the Abbott platform were strong (R = 0.82, P &amp;lt; 0.001; R = 0.89, P &amp;lt; 0.001; R = 0.91, P &amp;lt; 0.001). The Analyzer showed continued good mechanical performance, with stable and repeatable operations (calibrations, quality controls). Introducing a stricter sampling protocol and improvements in the clot-detecting system led to a decrease in the number of clotted samples and false-negative results. Outcomes were not affected by measurements performed either by nurses or laboratory staff.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intraoperative PTH monitoring during parathyroid surgery can be done accurately, simply, and quickly in whole blood using the Analyzer.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znae101","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T15:53:53Z","timestamp":1714751633000},"source":"Crossref","is-referenced-by-count":9,"title":["Ultrafast intraoperative parathyroid hormone monitoring system: prospective, multicentre, clinical validity study"],"prefix":"10.1093","volume":"111","author":[{"given":"Tom R","family":"Kurzawinski","sequence":"first","affiliation":[{"name":"Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, London, UK"},{"name":"Endocrine Surgery unit, London Clinic Hospitals , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zielke","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie am Diakonieklinikum Stuttgart , Stuttgart , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Busch","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie am Diakonieklinikum Stuttgart , Stuttgart , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Wagner","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie am Diakonieklinikum Stuttgart , Stuttgart , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Soromani","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7990-6302","authenticated-orcid":false,"given":"Alaa","family":"Abdelsalam","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Abdel-Aziz","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia Rozalen","family":"Garcia","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery, University College London Hospitals NHS Foundation Trust, Great Ormond Street Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Matias","sequence":"additional","affiliation":[{"name":"Endocrine Surgery unit, London Clinic Hospitals , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujiwa","family":"Morley","sequence":"additional","affiliation":[{"name":"Endocrine Surgery unit, London Clinic Hospitals , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Barth","sequence":"additional","affiliation":[{"name":"Endocrine Surgery unit, London Clinic Hospitals , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin A","family":"Smaxwil","sequence":"additional","affiliation":[{"name":"Endokrine Chirurgie am Diakonieklinikum Stuttgart , Stuttgart , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"2024052714210039000_znae101-B1","first-page":"1121","article-title":"Intraoperative measurement of parathyroid hormone in the surgical management of hyperparathyroidism","volume":"104","author":"Nussbaum","year":"1988","journal-title":"Surgery"},{"key":"2024052714210039000_znae101-B2","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S0002-9610(05)80101-1","article-title":"A new, practical intraoperative parathyroid hormone assay","volume":"168","author":"Irvin","year":"1994","journal-title":"Am J Surg"},{"key":"2024052714210039000_znae101-B3","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1007\/s00268-004-7708-6","article-title":"Quick intraoperative parathyroid hormone assay: surgical adjunct to allow limited parathyroidectomy, improve success rate, and predict outcome","volume":"28","author":"Irvin","year":"2004","journal-title":"World J Surg"},{"key":"2024052714210039000_znae101-B4","first-page":"4172","article-title":"Modern parathyroid surgery and intra-operative hormone monitoring","volume":"09","author":"Shawky","year":"2018","journal-title":"J Steroids and Hormonal Sci"},{"key":"2024052714210039000_znae101-B5","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1309\/6PFD-01B7-QV3G-GFN6","article-title":"Intraoperative vs central laboratory PTH testing during parathyroidectomy surgery","volume":"31","author":"Wians","year":"2000","journal-title":"Lab Med"},{"key":"2024052714210039000_znae101-B6","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1007\/s40618-020-01201-z","article-title":"Influence of common clinical variables on intraoperative parathyroid hormone monitoring during surgery for primary hyperparathyroidism","volume":"43","author":"Shawky","year":"2020","journal-title":"J Endocrinol Invest"},{"key":"2024052714210039000_znae101-B7","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/cen.13882","article-title":"Impact of intraoperative parathyroid hormone monitoring on the management of patients with primary hyperparathyroidism","volume":"90","author":"Shawky","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2024052714210039000_znae101-B8","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s00423-023-02848-x","article-title":"A 15-year experience: intraoperative parathyroid hormone assay for the management of primary hyperparathyroidism in a UK endocrine surgical unit","volume":"408","author":"Patel","year":"2023","journal-title":"Langenbecks Arch Surg"},{"key":"2024052714210039000_znae101-B9","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.surg.2005.06.046","article-title":"Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive 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