{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:59:28Z","timestamp":1790067568470,"version":"4.0.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Hemolysis is a common preanalytical interference in clinical laboratories, affecting up to 4% of blood samples. It can significantly impact the accuracy of test results, potentially leading to misdiagnosis and inappropriate treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To quantify the effects of hemolysis on routine clinical biochemistry parameters by comparing visual assessment with machine-based hemolysis indices (HIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted at AIIMS, Kalyani, from 2021 to 2023. Residual serum samples were used to assess the impact of mechanically induced hemolysis on 40 biochemical parameters measured using a Vitros 4600 analyzer. A semiquantitative visual grading scale was developed and compared to the analyzer\u2019s quantitative HI thresholds. Discrepancies in sample rejection rates between visual and automated methods were analyzed using the hospital\u2019s electronic health record database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis:<\/jats:title>\n                    <jats:p>Data analysis included calculating rejection rates and comparing differences between visual and HI-based methods for each analyte.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Visual assessment categorized most samples as \u201cno hemolysis\u201d (91.86%\u2013100%), with mild hemolysis (1.43%\u20139.09%) being common and severe hemolysis (0.41%\u20130.62%) rare. HI-based detection showed higher rejection rates for analytes such as potassium (1.58% higher), phosphate (1.07%), and liver enzymes. Conversely, lower rejection rates were observed for creatinine (+0.75%), urea (+0.79%), and electrolytes. Discrepancies exceeding 0.5% were noted for frequently tested analytes, raising the concerns about the reliability of visual assessment for specific parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Optimizing hemolysis assessment protocols by aligning HI thresholds with analytical sensitivity and clinical needs shows promise for improving laboratory result accuracy and patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_211_25","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:00:46Z","timestamp":1789531246000},"page":"1522-1529","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Visual Assessment and Hemolysis Index in Detecting Hemolysis across Common Biochemical Assay: Implications for Sample Rejection in Clinical Laboratory Practice"],"prefix":"10.4103","volume":"25","author":[{"given":"Sibasish","family":"Sahoo","sequence":"first","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaushik","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atanu Kumar","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyan","family":"Goswami","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"R1-20260922","doi-asserted-by":"crossref","first-page":"e0262748","DOI":"10.1371\/journal.pone.0262748","article-title":"The incidence rate and influence factors of hemolysis, lipemia, icterus in fasting serum biochemistry specimens","volume":"17","author":"Tian","year":"2022","journal-title":"PLoS One"},{"key":"R2-20260922","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1309\/AJCPDUDE1HRA0YMR","article-title":"Validation of hemolysis index thresholds optimizes detection of clinically significant hemolysis","volume":"143","author":"Goyal","year":"2015","journal-title":"Am J Clin Pathol"},{"key":"R3-20260922","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1515\/CCLM.2009.218","article-title":"Multicenter evaluation of the hemolysis index in automated clinical chemistry systems","volume":"47","author":"Lippi","year":"2009","journal-title":"Clin Chem Lab Med"},{"key":"R4-20260922","doi-asserted-by":"crossref","first-page":"143","DOI":"10.3109\/10408363.2011.600228","article-title":"Hemolyzed specimens: A major challenge for emergency departments and clinical laboratories","volume":"48","author":"Lippi","year":"2011","journal-title":"Crit Rev Clin Lab Sci"},{"key":"R5-20260922","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1515\/cclm-2017-1104","article-title":"European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE). Practical recommendations for managing hemolyzed samples in clinical chemistry testing","volume":"56","author":"Lippi","year":"2018","journal-title":"Clin Chem Lab Med"},{"key":"R6-20260922","first-page":"217","article-title":"Visual hemolysis Index for routine clinical chemistry laboratory parameters","volume":"5","author":"Hyder","year":"2018","journal-title":"Int J Clin Biochem Res"},{"key":"R7-20260922","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/j.1537-2995.2004.03315.x","article-title":"Visual assessment of hemolysis in red blood cell units and segments can be deceptive","volume":"44","author":"Janatpour","year":"2004","journal-title":"Transfusion"},{"key":"R8-20260922","doi-asserted-by":"crossref","DOI":"10.3892\/br.2021.1467","article-title":"Assessing the Influence of True Hemolysis Occurring in Patient Samples on Emergency Clinical Biochemistry Tests Results Using the VITROS\u00ae 5600 Integrated 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threshold","volume":"11","author":"Yang","year":"2022","journal-title":"Ann Palliat Med"},{"key":"R12-20260922","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1177\/0004563214533516","article-title":"Correcting laboratory results for the effects of interferences: An approach incorporating uncertainty of measurement","volume":"52","author":"Jones","year":"2015","journal-title":"Ann Clin Biochem"},{"key":"R13-20260922","first-page":"143","article-title":"Current methods of haemolysis detection and reporting as a source of risk to patient safety: A narrative review","volume":"37","author":"McCaughey","year":"2016","journal-title":"Clin Biochem Rev"},{"key":"R14-20260922","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10408363.2019.1664391","article-title":"Managing hemolyzed samples in clinical laboratories","volume":"57","author":"Simundic","year":"2020","journal-title":"Crit Rev Clin Lab 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