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Preanalytical and analytical factors in the mean platelet volume: a potential cause of heterogeneity in studies of erectile dysfunction

International Journal of Impotence Research volume 35, pages 492–493 (2023)Cite this article

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I read with interest the article entitled “Mean platelet volume as a predictive marker of erectile dysfunction: a meta-analysis” by Rasyid et al. which was recently published by IJIR: Your Sexual Medicine Journal [1]. I congratulate Rasyid and colleagues for their valuable contribution to the literature on this subject. Since the complete blood cell count (CBC) is a widely available and frequently ordered laboratory test, the use of CBC analytes as biomarkers of disease is of potential value in many areas of human health. However, clinicians and researchers should be aware of the potential biases in CBC parameters caused by preanalytical and analytical factors that limit their usefulness in the clinical setting. I have the following specific comments regarding the reporting of the mean platelet volume (MPV) data in the studies used by Rasyid et al. in their meta-analysis.

MPV results can be affected by variables introduced in the preanalytical phase, most prominently time between phlebotomy and analysis, choice of anticoagulant, and storage/transport conditions [2]. Preanalytical phase biases may be particularly problematic for specimens collected in satellite clinics and analyzed in a central laboratory, compared to hospital inpatient specimens. Also, the lack of standardization of the MPV across different instrument platforms may introduce a bias in the analytical phase [3]. Since information about these variables is largely confined to the clinical laboratory literature, there may be a knowledge gap for clinicians and researchers regarding the technological limitations of CBC analytes including the MPV. To address whether these variables were addressed in the papers used by Rasyid et al. in their meta-analysis, I reviewed the full text of each of the articles and extracted data regarding the reporting of 1) clinical setting, 2) time between phlebotomy and analysis, 3) anticoagulant, 4) storage/transport, and 5) instrumentation platform. The data are summarized in Table 1. For all the articles that identified the clinical setting of their studies (n = 7), all were performed using CBCs collected in outpatient clinics. For six studies, the time between specimen collection and analysis was stated as being less than 2 h; the remaining studies did not indicate this time interval. Six studies mentioned that specimens were collected in tubes containing Ethylenediaminetetraacetic acid (EDTA); the collection tube was not noted in the other studies. Specimen storage and transport conditions were not described for any of the studies. The CBC instruments used in the study were noted in only five articles, and included Sysmex (n = 1), Abbott (n = 3), Coulter (n = 1) analyzers.

Table 1 Reported preanalytical and analytical factors in the studies included in the meta-analysis of Rasyid et al.
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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Rasyid N, Harjanggi M, Atmoko W, Birowo P. Mean platelet volume as a predictive marker of erectile dysfunction: a meta-analysis. Int J Impot Res. 2022. https://doi.org/10.1038/s41443-021-00523-7. Online ahead of print.

  2. Frater JL. Comments on: “Is mean platelet volume related to disease activity in systemic lupus erythematosus?”. Int J Clin Pract. 2021;75:e14954. Int J Clin Pract. 2021;29:e14676

    PubMed  Google Scholar 

  3. Buttarello M, Mezzapelle G, Plebani M. Effect of preanalytical and analytical variables on the clinical utility of mean platelet volume. Clin Chem Lab Med. 2018;56:830–7.

    Article  PubMed  Google Scholar 

  4. Imrey PB. Limitations of meta-analyses of studies with high heterogeneity. JAMA Netw Open. 2020;3:e1919325.

    Article  PubMed  Google Scholar 

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  1. Department of Pathology and Immunology, Washington University, St Louis, MO, USA

    John L. Frater

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Correspondence to John L. Frater.

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Frater, J.L. Preanalytical and analytical factors in the mean platelet volume: a potential cause of heterogeneity in studies of erectile dysfunction. Int J Impot Res 35, 492–493 (2023). https://doi.org/10.1038/s41443-022-00577-1

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