A Critical Appraisal of the Use of Bloodspot Analysis for Biochemical Testing

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Introduction: Dried bloodspot analysis is a micro-sampling technique that utilises capillary whole blood samples obtained by a prick of the finger or heel. The micro-volume sample is then applied to a filter paper to be extracted and analysed by different methods such as liquid chromatography tandem mass spectrometry, or immunoassay. Even though DBS is well-established for newborn screening programs around the world, it has more recently been applied to other areas of biochemical testing. Given the recent exponential growth of understanding and development of DBS analysis for biochemical application, it is appropriate to conduct a literature review to discuss the DBS method in-depth. Aims: To critically review literature around bloodspot testing, to survey analytes available for dried blood spot analysis, and to consider the challenges of this testing format. Methods: To achieve the aims, I performed an extended literature review of relevant existing literature from 2015 to 2020. A keyword search of the Medline database was conducted using terms that included “dried blood spot”, “biochemical dried blood spot”, “DBS and dried blood spot”. Furthermore, the database was restricted to English language only, and the species was mostly restricted to humans with some minor exception to include animals. Results: Following the applied search criteria, I retrieved and utilized 73 references for this review. Studies were divided into those concerned with dried blood spot analysis procedure or the applications of dried blood spot testing. Conclusion: Dried bloodspot analysis presents many advantages in the bioanalytical field that seems unmatched, but these advantages bring along some difficult challenges that require innovative solutions to present DBS as a reliable method that can be accepted world-wide. It is critical to realise the significant role that should be given to organisations that are focused solely on bloodspot analysis in accelerating the growth and providing evidence-based guidelines.