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Theodorsson, Elvar, ProfessorORCID iD iconorcid.org/0000-0003-0756-7723
Publications (10 of 206) Show all publications
Lim, C. Y., Lee, X., Tran, M. T., Markus, C., Loh, T. P., Ho, C. S., . . . Zakaria, R. (2024). Linearity assessment: deviation from linearity and residual of linear regression approaches. Clinical Chemistry and Laboratory Medicine, 62(10), 1918-1927
Open this publication in new window or tab >>Linearity assessment: deviation from linearity and residual of linear regression approaches
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2024 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 62, no 10, p. 1918-1927Article in journal (Refereed) Published
Abstract [en]

In this computer simulation study, we examine four different statistical approaches of linearity assessment, including two variants of deviation from linearity (individual (IDL) and averaged (AD)), along with detection capabilities of residuals of linear regression (individual and averaged). From the results of the simulation, the following broad suggestions are provided to laboratory practitioners when performing linearity assessment. A high imprecision can challenge linearity investigations by producing a high false positive rate or low power of detection. Therefore, the imprecision of the measurement procedure should be considered when interpreting linearity assessment results. In the presence of high imprecision, the results of linearity assessment should be interpreted with caution. Different linearity assessment approaches examined in this study performed well under different analytical scenarios. For optimal outcomes, a considered and tailored study design should be implemented. With the exception of specific scenarios, both ADL and IDL methods were suboptimal for the assessment of linearity compared. When imprecision is low (3 %), averaged residual of linear regression with triplicate measurements and a non-linearity acceptance limit of 5 % produces <5 % false positive rates and a high power for detection of non-linearity of >70 % across different types and degrees of non-linearity. Detection of departures from linearity are difficult to identify in practice and enhanced methods of detection need development.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH, 2024
Keywords
linearity; imprecision; method verification; method validation; method evaluation
National Category
Medical Laboratory Technologies
Identifiers
urn:nbn:se:liu:diva-206328 (URN)10.1515/cclm-2023-1354 (DOI)001282355200001 ()39026453 (PubMedID)
Available from: 2024-08-16 Created: 2024-08-16 Last updated: 2025-02-09Bibliographically approved
Davidson, T., Sjödahl, R., Aldman, A., Lennmarken, C., Kammerlind, A.-S. & Theodorsson, E. (2024). Robot-assisted pelvic and renal surgery compared with laparoscopic or open surgery: Literature review of cost-effectiveness and clinical outcomes. Scandinavian Journal of Surgery, 113(1), 13-20
Open this publication in new window or tab >>Robot-assisted pelvic and renal surgery compared with laparoscopic or open surgery: Literature review of cost-effectiveness and clinical outcomes
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2024 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 113, no 1, p. 13-20Article, review/survey (Refereed) Published
Abstract [en]

Background and aim: The purpose of this study was to evaluate clinical experiences and cost-effectiveness by comparing robot-assisted surgery with laparoscopic- or open surgery for pelvic and renal operations. Methods: A narrative review was carried out. Results: When using robotic-assisted surgery, oncological and functional results are similar to after laparoscopic or open surgery. One exception may be a shorter survival in cancer of the cervix uteri. In addition, postoperative complications after robotic-assisted surgery are similar, bleeding and transfusion needs are less, and the hospital stay is shorter but the preparation of the operating theater before and after surgery and the operation times are longer. Finally, robot-assisted surgery has, in several studies, been reported to be not cost-effective primarily due to high investment costs. However, more recent studies provide improved cost-effectiveness estimates due to more effective preparation of the operating theater before surgery, improved surgeon experience, and decreased investment costs. Conclusions: Complications and functional and oncological outcomes after robot-assisted surgery are similar to open surgery and laparoscopic surgery. The cost-effectiveness of robot-assisted surgery is likely to equal or surpass the alternatives.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD, 2024
Keywords
Robot-assisted surgery; pelvic and renal surgery; cost-effectiveness; ergonomics
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-197512 (URN)10.1177/14574969231186283 (DOI)001044680300001 ()37555486 (PubMedID)
Available from: 2023-09-07 Created: 2023-09-07 Last updated: 2024-10-08Bibliographically approved
Badrick, T. & Theodorsson, E. (2024). Six Sigma - is it time to re-evaluate its value in laboratory medicine?. Clinical Chemistry and Laboratory Medicine, 62(12), 2398-2400
Open this publication in new window or tab >>Six Sigma - is it time to re-evaluate its value in laboratory medicine?
2024 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 62, no 12, p. 2398-2400Article in journal, Editorial material (Other academic) Published
Abstract [en]

The Sigma metric is widely used in laboratory medicine.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH, 2024
Keywords
assay performance; Sigma metric; quality improvement
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-204913 (URN)10.1515/cclm-2024-0377 (DOI)001242330000001 ()38856672 (PubMedID)
Available from: 2024-06-17 Created: 2024-06-17 Last updated: 2024-12-12Bibliographically approved
Loh, T. P., Cooke, B. R., Tran, T. C., Markus, C., Zakaria, R., Ho, C. S., . . . Greaves, R. F. (2024). The LEAP checklist for laboratory evaluation and analytical performance characteristics reporting of clinical measurement procedures. Annals of Clinical Biochemistry, 61(1), 3-7
Open this publication in new window or tab >>The LEAP checklist for laboratory evaluation and analytical performance characteristics reporting of clinical measurement procedures
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2024 (English)In: Annals of Clinical Biochemistry, ISSN 0004-5632, E-ISSN 1758-1001, Vol. 61, no 1, p. 3-7Article in journal (Refereed) Published
Abstract [en]

Reporting a measurement procedure and its analytical performance following method evaluation in a peer-reviewed journal is an important means for clinical laboratory practitioners to share their findings. It also represents an important source of evidence base to help others make informed decisions about their practice. At present, there are significant variations in the information reported in laboratory medicine journal publications describing the analytical performance of measurement procedures. These variations also challenge authors, readers, reviewers and editors in deciding the quality of a submitted manuscript. The International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Method Evaluation Protocols (IFCC WG-MEP) developed a checklist and recommends its adoption to enable a consistent approach to reporting method evaluation and analytical performance characteristics of measurement procedures in laboratory medicine journals. It is envisioned that the LEAP checklist will improve the standardisation of journal publications describing method evaluation and analytical performance characteristics, improving the quality of the evidence base that is relied upon by practitioners.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
Emerging technology(ies); method validation; method verification
National Category
Software Engineering
Identifiers
urn:nbn:se:liu:diva-201884 (URN)10.1177/00045632231206029 (DOI)37838926 (PubMedID)
Available from: 2024-03-25 Created: 2024-03-25 Last updated: 2024-05-06
Theodorsson, E. (2023). Correction to: Estimating Analytical Errors of Glomerular Filtration Rate Measurement (Volume 68, Issue 9, 2022, Pages 1211–1218). Clinical Chemistry, 69(4), 429-429
Open this publication in new window or tab >>Correction to: Estimating Analytical Errors of Glomerular Filtration Rate Measurement (Volume 68, Issue 9, 2022, Pages 1211–1218)
2023 (English)In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 69, no 4, p. 429-429Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2023
Identifiers
urn:nbn:se:liu:diva-201905 (URN)10.1093/clinchem/hvac162 (DOI)000854148900001 ()36111551 (PubMedID)
Available from: 2024-03-26 Created: 2024-03-26 Last updated: 2025-02-04Bibliographically approved
Preinbergs, J., Sundström-Poromaa, I., Theodorsson, E., Ström, J. O. & Ingberg, E. (2023). Effect of cosmetic hair treatment and natural hair colour on hair testosterone concentrations. PLOS ONE, 18(10), e0291812-e0291812
Open this publication in new window or tab >>Effect of cosmetic hair treatment and natural hair colour on hair testosterone concentrations
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 10, p. e0291812-e0291812Article in journal (Refereed) Published
Abstract [en]

Purpose: Testosterone analysis in hair allows for retrospective evaluation of endogenous testosterone concentrations, but studies devoted to investigating confounders in hair testosterone analysis have hitherto been scarce. The current study examined the stability of testosterone concentrations between two hair samples collected three months apart and investigated two potential confounding factors: natural hair colour and cosmetic hair treatments.

Methods: Testosterone was analysed with an in-house radioimmunoassay with a limit of detection adequate for the purpose.

Results: The testosterone concentrations from the two samplings, at baseline and three months later, had an intra-individual correlation of moderate strength (rho = 0.378, p<0.001, n = 146). Hair treatment, such as colouring or bleaching, seemed to increase testosterone concentrations (p = 0.051, n = 191, and in a paired analysis in a subset of the cohort p = 0.005, n = 24), while no effect of natural colour in untreated hair (p = 0.133) could be detected.

Conclusion: The current results suggest that cosmetic hair treatments need to be considered in hair testosterone analyses and demonstrate the utility of a radioimmunoassay to reliably measure testosterone concentrations in small hair samples in women.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-201625 (URN)10.1371/journal.pone.0291812 (DOI)001192241100009 ()37819888 (PubMedID)2-s2.0-85173908690 (Scopus ID)
Funder
Swedish Research Council, K2013-99X-22269-01-3
Available from: 2024-03-14 Created: 2024-03-14 Last updated: 2025-02-01Bibliographically approved
Babarro, I., Ibarluzea, J., Theodorsson, E., Fano, E., Lebeña, A., Guxens, M., . . . Andiarena, A. (2023). Hair cortisol as a biomarker of chronic stress in preadolescents: influence of school context and bullying. Child Neuropsychology, 29(5), 742-759
Open this publication in new window or tab >>Hair cortisol as a biomarker of chronic stress in preadolescents: influence of school context and bullying
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2023 (English)In: Child Neuropsychology, ISSN 0929-7049, E-ISSN 1744-4136, Vol. 29, no 5, p. 742-759Article in journal (Refereed) Published
Abstract [en]

Bullying has been identified as the most common form of aggression and a major source of stress among children and adolescents. The main objective of this study was to analyze the association that school context in general and bullying in particular might have with hair cortisol concentration (HCC), examining the effect of executive function and sex on this association. The study included 659 11-year-old preadolescents from the cohorts of Gipuzkoa and Sabadell of the INMA (INfancia y Medio Ambiente-Children and Environment) project. We gathered information about school-related factors (bullying, school environment, problems with peers and academic performance) and executive function (risky decision-making). Hair samples were collected to measure cortisol concentrations and Structural Equation Modeling was used to examine associations between school-related factors, executive function and HCC. Results showed that being involved as a bully/victim was related to higher HCC and, higher HCC was associated with poorer executive function. This study may contribute to a better understanding of the consequences that chronic exposure to a stressful factors may have on preadolescents' health and developmental outcomes. Besides, our results are relevant for designing programs for prevention and intervention, which could modify individual physiological responses to stress and reduce the effects of stress on the health.

Place, publisher, year, edition, pages
Informa UK Limited, 2023
Keywords
Hair cortisol; bullying; executive function; preadolescents; school context
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-201624 (URN)10.1080/09297049.2022.2115991 (DOI)000847410300001 ()36036166 (PubMedID)2-s2.0-85136881289 (Scopus ID)
Available from: 2024-03-14 Created: 2024-03-14 Last updated: 2025-02-01Bibliographically approved
Lööv, A., Högberg, C., Lilja, M., Theodorsson, E., Hellström, P., Metsini, A. & Olsson, L. (2022). Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol. Diagnostic and Prognostic Research, 6(1), Article ID 16.
Open this publication in new window or tab >>Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients: a study protocol
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2022 (English)In: Diagnostic and Prognostic Research, E-ISSN 2397-7523, Vol. 6, no 1, article id 16Article in journal (Refereed) Published
Abstract [en]

Background: There is increasing evidence supporting the use of faecal immunochemical tests (FIT) in patients reporting symptoms associated with colorectal cancer (CRC), but most studies until now have focused on selected subjects already referred for investigation. We therefore set out to determine the accuracy and predictive values of FIT in a primary care population.

Method: A prospective, multicentre, single-gated comparative diagnostic study on quantitative FIT in patients aged 40 years and above presenting in primary care with symptoms associated with CRC will be conducted. Patients representing the whole spectrum of severity of such symptoms met with in primary care will be eligible and identified by GPs. Participants will answer a short form on symptoms during the last month. They will provide two faecal samples from two separate days. Analyses will be performed within 5 days (QuikRead go®, Aidian Oy). The analytical working range is 10-200 μg Hb/g faeces. Reference test will be linked to the Swedish Colorectal Cancer Registry up to 2 years after inclusion. Accuracy, area under ROC curves, and predictive values will be calculated for one FIT compared to the highest value of two FIT and at cutoff < 10, 10-14.9, 15-19.9 and ≥ 20 μg Hb/g faeces. Subgroup analyses will be conducted for patients with anaemia and those reporting rectal bleeding. A model-based cost-effectiveness analysis based on the clinical accuracy study will be performed. Based on previous literature, we hypothesized that the sensitivity of the highest value of two FIT at cutoff 10 μg Hb/g faeces will be 95% (95% CI + / - 15%). The prevalence of CRC in the study population was estimated to be 2%, and the rate of non-responders to be 1/6. In all, 3000 patients will be invited at 30 primary care centres.

Discussion: This study will generate important clinical real-life structured data on accuracy and predictive values of FIT in the most critical population for work-up of CRC, i.e. patients presenting with at times ambiguous symptoms in primary care. It will help establish the role of FIT in this large group.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Colorectal cancer; Diagnostic accuracy study; Primary care; Quantitative faecal immunochemical test; Sensitivity
National Category
Cancer and Oncology General Practice
Identifiers
urn:nbn:se:liu:diva-191943 (URN)10.1186/s41512-022-00129-7 (DOI)001210931700001 ()
Funder
Swedish Cancer SocietyÖrebro UniversityNyckelfonden
Available from: 2023-02-27 Created: 2023-02-27 Last updated: 2024-11-15Bibliographically approved
Martinez-Serrano, C., Marteinsdottir, I., Josefsson, A., Sydsjö, G., Theodorsson, E. & Rodriguez-Martinez, H. (2022). Prenatal stress, anxiety and depression alter transcripts, proteins and pathways associated with immune responses at the maternal-fetal interface. Biology of Reproduction, 106(3), 449-462
Open this publication in new window or tab >>Prenatal stress, anxiety and depression alter transcripts, proteins and pathways associated with immune responses at the maternal-fetal interface
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2022 (English)In: Biology of Reproduction, ISSN 0006-3363, E-ISSN 1529-7268, Vol. 106, no 3, p. 449-462Article in journal (Refereed) Published
Abstract [en]

During pregnancy, the immune system is modified to allow developmental tolerance of the semi-allogeneic fetus and placenta to term. Pregnant women suffering from stress, anxiety, and depression show dysfunctions of their immune system that may be responsible for fetal and/or newborn disorders, provided that placental gene regulation is compromised. The present study explored the effects of maternal chronic self-perceived stress, anxiety, and depression during pregnancy on the expression of immune-related genes and pathways in term placenta. Pregnancies were clinically monitored with the Beck Anxiety Inventory (BAI) and Edinburgh Postnatal Depression Scale (EPDS). A cutoff threshold for BAI/EPDS of 10 divided patients into two groups: Index group (&gt;10, n = 11) and a Control group (&lt;10, n = 11), whose placentae were sampled at delivery. The placental samples were subjected to RNA-Sequencing, demonstrating that stress, anxiety, and depression during pregnancy induced a major downregulation of placental transcripts related to immune processes such as T-cell regulation, interleukin and cytokine signaling, or innate immune responses. Expression differences of main immune-related genes, such as CD46, CD15, CD8 alpha & beta ILR7 alpha, and CCR4 among others, were found in the Index group (P &lt; 0.05). Moreover, the key immune-like pathway involved in humoral and cellular immunity named "Primary immunodeficiency" was significantly downregulated in the Index group compared with Controls. Our results show that mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy. These findings may help unveil mechanisms ruling the impact of maternal psychiatric symptoms and lead to new prevention/intervention strategies in complicated pregnancies. Summary Sentence Mechanisms ruling immune system functions are compromised at the maternal-fetal interface following self-perceived depressive symptoms and anxiety during pregnancy.

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
antenatal stress; immune system; term-placentae; RNA-Seq; human
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-183253 (URN)10.1093/biolre/ioab232 (DOI)000756755300001 ()34935902 (PubMedID)
Available from: 2022-03-04 Created: 2022-03-04 Last updated: 2023-12-28Bibliographically approved
Sjödahl, R., Davidson, T., Aldman, Å., Lennmarken, C., Kammerlind, A.-S., Gustavsson, E. & Theodorsson, E. (2022). Robotassisterad bäcken- och njurkirurgi – en utvärdering. Läkartidningen, 119, Article ID 21172.
Open this publication in new window or tab >>Robotassisterad bäcken- och njurkirurgi – en utvärdering
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2022 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 119, article id 21172Article, review/survey (Refereed) Published
Abstract [en]

Current studies indicate that robotic-assisted surgery is not inferior to laparoscopic or open surgery regarding oncologic or functional outcomes. An exception may be uterine cervix cancer, where the survival after minimal invasive surgery might not be as good as after open surgery. There is less bleeding and need for blood transfusion after robotic-assisted surgery, and postoperative complications are similar to open or laparoscopic surgery. Robotic-assisted surgery offers ergonomic advantages compared to laparoscopic surgery. The effect of the surgical learning curve is not sufficiently studied. Presently robotic-assisted surgery is not cost-effective due to high costs of investments. The operation is more time consuming than laparoscopic or open surgery with risks of delaying and cancellation of other operations.

Abstract [sv]

Onkologiskt och funktionellt resultat vid robotassisterad kirurgi skiljer sig inte från laparoskopisk eller öppen kirurgi. Ett undantag kan vara sämre överlevnad vid cervixcancer.

Robotassisterad kirurgi är inte kostnadseffektiv i dagsläget på grund av investeringskostnaderna.

Robotassisterad kirurgi erbjuder ergonomiska fördelar och ger ingen ökning av postoperativa komplikationer. Operationstiderna är längre, men möjligen är blödning och transfusionsbehov mindre och vårdtiden kortare.

Inlärningseffekterna är ofullständigt undersökta.

Det finns etiska skäl att vara observant på undanträngningseffekter till följd av ökad användning av robotkirurgi.

Place, publisher, year, edition, pages
Stockholm, Sweden: Sveriges läkarförbund, 2022
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:liu:diva-192046 (URN)35471726 (PubMedID)
Available from: 2023-02-28 Created: 2023-02-28 Last updated: 2023-05-02Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-0756-7723

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