Preanalytics: The Imprecision in Precision Medicine

In an era of precision medicine, preanalytics remains the most important and pervasive source of imprecision in the practice of pathology. Poor-quality samples blunt clinical decision-making effectiveness, affect the outcomes for individual patients and entire populations, and hamper the development of new diagnostics and therapies.

To date, the clinical community has not clearly defined patient biospecimen quality standards, making it difficult to identify specimens that are fit for purpose. While attention to preanalytical issues has lagged, the gap is becoming critical for precision medicine. Recent evidence-based preanalytical recommendations offer baseline standards for biospecimen collection, handling, and processing that merit our attention and control.

1. Define preanalytics and identify the factors encompassed by preanalytics.
2. Give examples of the preanalytical factors that are most likely to compromise the molecular quality and composition of tissue and blood specimens.
3. Summarize the recommendations for controlling and recording key preanalytical factors that the CAP has put forward for patient biospecimens to insure their molecular integrity.

Handout (PDF)

Carolyn Compton, MD, PhD, FCAP