Standard Document
First Edition
Clinical Chemistry and Toxicology

CLSI C50

Mass Spectrometry in the Clinical Laboratory: General Principles and Guidance

CLSI C50 offers essential guidance for implementing and operating mass spectrometry (MS) systems in clinical laboratories. This guideline covers quality assurance, method verification, instrument troubleshooting, and sample preparation, ensuring accurate and precise mass measurement across instruments. Designed for clinical chemists, health practitioners, and laboratory professionals, C50 provides a foundational resource for maintaining optimal MS performance and understanding its applications, limitations, and result interpretation in clinical testing.

This reaffirmed document has been reviewed and confirmed as suitable to remain published without revision to content, as of January 2023. 

October 29, 2007
Donald H. Chace, PhD

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Abstract

Clinical and Laboratory Standards Institute document C50-A—Mass Spectrometry in the Clinical Laboratory: General Principles and Guidance; Approved Guideline provides a general understanding of MS and the principles that dictate its application in the clinical laboratory. It includes guidance, references, and quality assurance markers that will assist with the implementation and correct operation of an MS system for its many applications. Information on maintaining optimum performance, approaches to ensuring accurate and precise mass measurement, verification of methods, quality control of assays within and between instruments, instrument troubleshooting, sample preparation, interpretation of results, and limitations of the technology is included. This document is intended to be a basic resource for clinical chemists; health practitioners; instrument manufacturers; and those responsible for developing standards, implementing policy, and teaching.

Scope

This document provides an introduction to, and guidance, resources, and references for, the use of mass spectrometry (MS) in the clinical laboratory. It serves to illuminate specific issues in mass spectrometric analyses that must be considered when the technology is applied to clinical testing. This guideline aims to educate both the practitioners of MS and the medical professionals who use the results produced by the instruments for the diagnosis, characterization, or monitoring of disease. Through knowledge of this material, the medical professional will better understand why MS may be preferred for a clinical application. They will also become more informed consumers when selecting a diagnostic laboratory to provide MS services. This document is also intended to be a basic resource for instrument manufacturers; regulatory agencies; and those responsible for developing standards, implementing policy, and teaching. 

Selected examples of “routinely utilized clinical assays” are used to describe the fundamental principles of MS. These examples are primarily from tests for small molecules and metabolites. There is also a brief discussion of the MS analysis of other analytes that are either not common in clinical chemistry application at the time of this writing or are highly specialized, warranting their own document. These analytes include elements, peptides, proteins, and other biopolymers, including oligonucleotides. 

A description of all current clinical applications of MS is beyond the scope of this document. Therefore, the goal of this guideline is to provide a basic understanding of the technology and how it should be used in the clinical laboratory with an emphasis on: 

• advantages and disadvantages; 

• precautions required in its use; 

• quality control awareness; 

• assay verification/validation; 

• approaches to reporting results; and 

• communication of the data. 

Portions of published and validated clinical methods are discussed in more detail to illustrate these concepts when required.

Product Details
C50AE
1-56238-648-4
112
Additional Details

This archived document is no longer being reviewed through the CLSI Consensus Document Development Process. However, this document is technically valid and because of its value to the laboratory community, it is being retained in CLSI’s library.

This document is available in electronic format only.

Authors
Donald H. Chace, PhD
John R. Barr, PhD
Mark W. Duncan, PhD
Dietrich Matern, MD
Michael R. Morris, PhD, FRSC
Darryl Erik Palmer-Toy, MD, PhD
Alan L. Rockwood, PhD
Gary Siuzdak, PhD
Andrea Urbani, PhD
Alfred L. Yergey, PhD
Y. Michael Chan, PhD
Abstract

Clinical and Laboratory Standards Institute document C50-A—Mass Spectrometry in the Clinical Laboratory: General Principles and Guidance; Approved Guideline provides a general understanding of MS and the principles that dictate its application in the clinical laboratory. It includes guidance, references, and quality assurance markers that will assist with the implementation and correct operation of an MS system for its many applications. Information on maintaining optimum performance, approaches to ensuring accurate and precise mass measurement, verification of methods, quality control of assays within and between instruments, instrument troubleshooting, sample preparation, interpretation of results, and limitations of the technology is included. This document is intended to be a basic resource for clinical chemists; health practitioners; instrument manufacturers; and those responsible for developing standards, implementing policy, and teaching.

Scope

This document provides an introduction to, and guidance, resources, and references for, the use of mass spectrometry (MS) in the clinical laboratory. It serves to illuminate specific issues in mass spectrometric analyses that must be considered when the technology is applied to clinical testing. This guideline aims to educate both the practitioners of MS and the medical professionals who use the results produced by the instruments for the diagnosis, characterization, or monitoring of disease. Through knowledge of this material, the medical professional will better understand why MS may be preferred for a clinical application. They will also become more informed consumers when selecting a diagnostic laboratory to provide MS services. This document is also intended to be a basic resource for instrument manufacturers; regulatory agencies; and those responsible for developing standards, implementing policy, and teaching. 

Selected examples of “routinely utilized clinical assays” are used to describe the fundamental principles of MS. These examples are primarily from tests for small molecules and metabolites. There is also a brief discussion of the MS analysis of other analytes that are either not common in clinical chemistry application at the time of this writing or are highly specialized, warranting their own document. These analytes include elements, peptides, proteins, and other biopolymers, including oligonucleotides. 

A description of all current clinical applications of MS is beyond the scope of this document. Therefore, the goal of this guideline is to provide a basic understanding of the technology and how it should be used in the clinical laboratory with an emphasis on: 

• advantages and disadvantages; 

• precautions required in its use; 

• quality control awareness; 

• assay verification/validation; 

• approaches to reporting results; and 

• communication of the data. 

Portions of published and validated clinical methods are discussed in more detail to illustrate these concepts when required.

Additional Details

This archived document is no longer being reviewed through the CLSI Consensus Document Development Process. However, this document is technically valid and because of its value to the laboratory community, it is being retained in CLSI’s library.

This document is available in electronic format only.

Authors
Donald H. Chace, PhD
John R. Barr, PhD
Mark W. Duncan, PhD
Dietrich Matern, MD
Michael R. Morris, PhD, FRSC
Darryl Erik Palmer-Toy, MD, PhD
Alan L. Rockwood, PhD
Gary Siuzdak, PhD
Andrea Urbani, PhD
Alfred L. Yergey, PhD
Y. Michael Chan, PhD