Sheffield CH publish a TMAU document

Sheffield Children's Hospital have published a TMAU document on their website.
It's an ABRIDGED version of the powerpoint they presented to the UCL London TMAU community group.
While the document is welcome it's still a long way from what a lone national test lab could offer the public.
The lecture was to explain the differences between the 'old' TMAU test they did up to 2016, and the 'new' method.

Sheffield CH TMAU Powerpoint PDF

Page with document link

Some initial eye-catching about the document.

 Assay running for one year
 n = 725
 Includes repeat samples and monitoring patients,
including those on treatment
 147 results below limit of quantitation
 Very low levels, unable to provide quantitative result
 453 results within ref range for TMA and N-oxidation
 94 results outside ref ranges for TMA and N-oxidation
 8 results outside ref range for TMA, within ref range
for N-oxidation
 23 results within ref range for TMA, outside ref range
for N-oxidation
 Mainly known patients on dietary restriction

The document includes a graph of the 725 results

They say :

 Important to note:
 Results from the ‘old’ method cannot be directly
compared to those using our ‘new’ method
 Results obtained by our method cannot be
interpreted using other laboratories reference ranges
(such as those quoted on scientific papers)

Whether that is subjective cannot be confirmed.

Sample Exchange Program between the 4 main known  TMAU labs :
The 4 best known TMAU test labs seem to test each others samples in a small survey each year, presumably to double check results.
It's not clear what this entails. Probably retesting samples to see if they get same results, even though they all use different methods. 
Perhaps they could add South Africa to their program.

Ref ranges :
These seem to have been taken from a 1997 paper (Maschke et al) and from 37 'control' samples to confirm.
1997 paper
Whether this ref range is conservative or 37 controls is standard is unknown.

So the document is welcome but still more for the public would be welcome.
Such as a TMAU page on the site where the public can get details how to test etc. 
People might think that a good minimum for a national test lab. 

Comments are welcome.

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