{"text_format":"1","workbook":"xlsx","n_sheets":3,"sheets":["Instructions","Results","Settings"],"not_rendered":{"charts":1,"images":1,"macros":1,"external_links":0,"defined_names":9,"comments":1,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Instructions","index":0,"n_rows":37,"n_cols":3,"rows_kept":37,"cut":false,"hidden":false,"merged":[[12,1,12,2],[13,1,13,2],[14,1,14,2],[16,1,16,2],[27,1,27,2],[15,1,15,2],[0,0,0,2],[4,1,4,2],[6,1,6,2],[9,1,9,2],[10,1,10,2],[2,1,2,2],[3,1,3,2],[19,1,19,2],[24,1,24,2],[26,1,26,2],[33,1,33,2],[36,0,36,2],[28,1,28,2],[29,1,29,2]]}
["Instructions for GFR spreadsheet"]
[]
["*","Customize site specific parameters in the \"Settigs\" tab and or by editing the \"Results\" tab formatting."]
[1,"Process patient exam data in the \"Results\" tab:"]
[2,"Enter Patient Name, ID, Height, Weight, Date, Performing site and protocol in the first frame."]
[null,"-","The patient BSA is calculated automatically according to The Dupuis formula."]
[3,"Prepare Tc-99m DTPA patient dose: "]
[null,"-","370MBq (10 mCi) with imaging"]
[null,"-","37 MBq (1 mCi) without imaging"]
[4,"Accurately assay the syringe, with needle to be used for injection, in the calibrator and record in the second frame."]
[5,"Inject dose and record time of injection in third frame."]
[null,"-","If with imaging, injection should be perfomed on scanner bed with start of image acquisition."]
[6,"Measure the residual activity in the syringe and record along with time in the second frame."]
[7,"Image injection site to ensure venous injection"]
[8,"Withdraw blood samples of 9 to 10 ml at 2, 3, and 4 hours post-injection. Record the times in third frame. Elapsed times from injection are calculated automatically."]
[9,"Centrifuge the blood samples at >2000 g for 10 or until plasma separation is achieved."]
[10,"For diultion standard preparation:"]
[null,"-","Measure approximately 12.5 MBq (1/3 mCi) Tc-99m Pertechnetate activity in a syringe and record the time in the second frame. "]
[null,"-",{"$f":"_xlfn.CONCAT(\"Empty content of syringe into 3/4 full \",Settings!C4, \" mL volumetric flask. Measure and record the residual activity in the syringe. Top off the flask and mix vigoruosly.\")","v":"Empty content of syringe into 3/4 full 500 mL volumetric flask. Measure and record the residual activity in the syringe. Top off the flask and mix vigoruosly."}]
[11,{"$f":"_xlfn.CONCAT(\"Pipet two duplicate \", Settings!C5, \" µL samples into scintilator counter vials for each of the following:\")","v":"Pipet two duplicate 100 µL samples into scintilator counter vials for each of the following:"}]
[null,"-","Dilution standard"]
[null,"-","2 hour plasma"]
[null,"-","3 hour plasma"]
[null,"-","4 hour plasma"]
[12,"Count the samples along with two background samples in the scintilator counter using the appropriate protocol. Enter the counts in the forth frame."]
[13,"Enter the time of sample counting in the third frame and indicate if counts were obtained on the following day."]
[14,"Ensure that all quality assurance indicator are green check marks. Investigate and correct errors if not."]
[15,"The spreadsheet fits these plasma counts to an exponential clearance curve, and calculates counts at To, and the clearance half-life, T1/2. These values are plotted in the graph – check that they are reasonable."]
[16,"The spreadsheet also calculates the GFR and the modified GFR according to the formulas indicated. Check that these numbers are sensible and sign off at the bottom."]
[17,"Print the \"Results\" tab for a final report."]
[]
[]
["References:"]
["[1]","Klein R, et al., An electronic technetium-99m-diethylenetriaminepentaacetic acid glomerular filtration rate spreadsheet with novel embedded quality assurance features. Nucl Med Commun. 2019 Jan;40(1):30-40."]
[]
["Disclimer:"]
["By using our tool, you agree to these terms and conditions, made between you and the Ottawa Hospital Research Institute and the Ottawa Hospital. The template should be tailored to a clinic's needs and is provided solely as a guidance template. The template is provided as is, with no guarantees or warranties, and its use is at your own risk. It is not a licensed medical device in any jurisdiction.\n\nThe Ottawa Hospital Research Institute, the Ottawa Hospital, and its researchers, including Ran Klein, expressly disclaim all warranties of any kind regarding this tool, either express or implied, including, without limitation, warranties of title, non-infringement, and implied warranties of merchantability or fitness for a particular purpose.\n\nThe Ottawa Hospital Research Institute, the Ottawa Hospital, and its researchers, including Ran Klein, will have no liability for any damages, injury or any other loss whatsoever suffered as a result of use of, or reliance upon, this tool. In the case of loss, injury or damage of any kind to a person resulting from your use of this tool, you agree to indemnify and hold harmless the Ottawa Hospital Research Institute, the Ottawa Hospital, and its researchers, including Ran Klein, from any and all claims arising therefrom. \n"]

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[null,null,"GLOMERULAR  FILTRATION  RATE WORKSHEET",null,null,null,null,null,null,null,null,"Low Error","Low Warn","Reference","High Warn","High Error","Test value"]
["PATIENT","John, Doe",null,null,"HEIGHT(cm)",null,"Data Quality Assurance"]
["ID","Patient MRN",null,null,"WEIGHT(kg)"]
["DATE",{"$f":"NOW()","v":"2019-07-31T11:41:16.490"},null,null,"BSA (m2)",{"$f":"0.20247*(F2/100)^0.725*F3^0.425","v":0},{"$f":"IF(OR($Q4<$L4,$Q4>$P4),2,IF(OR($Q4<$M4,$Q4>$O4),1,0))","v":2},"BSA in range",null,null,null,0.25,0.5,null,3,3.5,{"$f":"F4","v":0}]
["PROTOCOL","GFR with Imaging",null,null,"SITE","Site 1"]
[]
["Set assay times only if different from injection time.",null,"Patient Dose",null,"Standard",null,{"$f":"IF(AND(D9<=C13,C13<=D10),0,2)","v":0},"Injection assay times"]
[null,null,"Activity (kBq)","Assay Time","Activity (kBq)","Assay Time",{"$f":"IF(F9<=F10,0,2)","v":0},"Standard assay times"]
["Pre assay",null,null,{"$f":"C13","v":"00:00:00"},null,{"$f":"C13","v":"00:00:00"},{"$f":"IF(OR($Q9<$L9,$Q9>$P9),2,IF(OR($Q9<$M9,$Q9>$O9),1,0))","v":2},"Injected activity match protocol",null,null,null,{"$f":"$N9*0.5","v":185000},{"$f":"$N9*0.7","v":258999.99999999997},{"$f":"IF($B$5=\"GFR with Imaging\",370000,37000)","v":370000},{"$f":"$N9*1.5","v":555000},{"$f":"$N9*2","v":740000},{"$f":"C11","v":0}]
["Residual assay",null,null,{"$f":"C13","v":"00:00:00"},null,{"$f":"C13","v":"00:00:00"},{"$f":"IF(OR($Q10<$L10,$Q10>$P10),2,IF(OR($Q10<$M10,$Q10>$O10),1,0))","v":2},"Standard activity match protocol",null,null,null,{"$f":"N10*0.4","v":5000},{"$f":"N10*0.6","v":7500},12500,{"$f":"N10*3","v":37500},{"$f":"N10*6","v":75000},{"$f":"E11","v":0}]
["Decayed to Injection",null,{"$f":"C9*EXP(-LN(2)/6.01*($C$13-D9)*24)-C10*EXP(-LN(2)/6.01*($C$13-D10)*24)","v":0},null,{"$f":"E9*EXP(-LN(2)/6.01*($C$13-F9)*24)-E10*EXP(-LN(2)/6.01*($C$13-F10)*24)","v":0},null,{"$f":"IF(OR($Q11<$L11,$Q11>$P11),2,IF(OR($Q11<$M11,$Q11>$O11),1,0))","v":{"$error":"#DIV/0!"}},"Injection residual activity",null,null,null,0,0,0,0.25,0.5,{"$f":"C10/C9","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,null,{"$f":"IF(OR($Q12<$L12,$Q12>$P12),2,IF(OR($Q12<$M12,$Q12>$O12),1,0))","v":{"$error":"#DIV/0!"}},"Standard prep. residual activity",null,null,null,0,0,0,0.8,0.9,{"$f":"E10/E9","v":{"$error":"#DIV/0!"}}]
["Time of Injection",null,null,"Injection site:"]
["Time of Plasma 1 (2 hr)",null,null,{"$f":"(C14-C13)*24*60","v":0}," Min. after injection",null,{"$f":"IF(OR($Q14<$L14,$Q14>$P14),2,IF(OR($Q14<$M14,$Q14>$O14),1,0))","v":2},null,null,null,null,{"$f":"N14-45","v":75},{"$f":"N14-15","v":105},120,{"$f":"N14+15","v":135},{"$f":"N14+45","v":165},{"$f":"D14","v":0}]
["Time of Plasma 2 (3 hr)",null,null,{"$f":"(C15-C13)*24*60","v":0},null,null,{"$f":"IF(OR($Q15<$L15,$Q15>$P15),2,IF(OR($Q15<$M15,$Q15>$O15),1,0))","v":2},"Sample time match protocol",null,null,null,{"$f":"N15-45","v":135},{"$f":"N15-15","v":165},180,{"$f":"N15+15","v":195},{"$f":"N15+45","v":225},{"$f":"D15","v":0}]
["Time of Plasma 3 (4 hr)",null,null,{"$f":"(C16-C13)*24*60","v":0},null,null,{"$f":"IF(OR($Q16<$L16,$Q16>$P16),2,IF(OR($Q16<$M16,$Q16>$O16),1,0))","v":2},null,null,null,null,195,225,240,255,285,{"$f":"D16","v":0}]
["Sample Counting",null,null,"on same day",null,{"$f":"EXACT(D17,\"on FOLLOWING day\")","v":false},{"$f":"IF(C17+IF(nextDay,24,0)-MAX(F10,C16)>0,0,2)","v":2},"Counting after samples prepared"]
[]
["SAMPLE","Sample 1","Sample 2","MEAN-BKGD","% Diff","z-score"]
[null,"(counts)","(counts)","(counts)"]
["Background",null,null,{"$f":"AVERAGE(B21:C21)","v":{"$error":"#DIV/0!"}},null,{"$f":"IF(D21=0,0,MAX(0,ABS($C21-$B21))/SQRT($D21))","v":{"$error":"#DIV/0!"}},{"$f":"IF(OR($Q21<$L21,$Q21>$P21),2,IF(OR($Q21<$M21,$Q21>$O21),1,0))","v":{"$error":"#DIV/0!"}},null,null,null,null,0,0,0,1.96,3.29,{"$f":"F21","v":{"$error":"#DIV/0!"}}]
["Standard",null,null,{"$f":"AVERAGE(B22:C22)-$D$21","v":{"$error":"#DIV/0!"}},{"$f":"ABS(B22-C22)/D22","v":{"$error":"#DIV/0!"}},{"$f":"ABS($C22-$B22)/2/SQRT(2*$D22+$D22^2*2*(Settings!$C$9^2+Settings!$C$8^2))/Bonferroni","v":{"$error":"#DIV/0!"}},{"$f":"IF(OR($Q22<$L22,$Q22>$P22),2,IF(OR($Q22<$M22,$Q22>$O22),1,0))","v":{"$error":"#DIV/0!"}},null,null,null,null,0,0,0,1.96,3.29,{"$f":"F22","v":{"$error":"#DIV/0!"}}]
["Plasma 1",null,null,{"$f":"AVERAGE(B23:C23)-$D$21","v":{"$error":"#DIV/0!"}},{"$f":"ABS(B23-C23)/D23","v":{"$error":"#DIV/0!"}},{"$f":"ABS($C23-$B23)/2/SQRT(2*$D23+$D23^2*2*(Settings!$C$9^2+Settings!$C$8^2))/Bonferroni","v":{"$error":"#DIV/0!"}},{"$f":"IF(OR($Q23<$L23,$Q23>$P23),2,IF(OR($Q23<$M23,$Q23>$O23),1,0))","v":{"$error":"#DIV/0!"}},"Sample 1 and 2 agreement",null,null,null,0,0,0,1.96,3.29,{"$f":"F23","v":{"$error":"#DIV/0!"}}]
["Plasma 2",null,null,{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"ABS($C24-$B24)/2/SQRT(2*$D24+$D24^2*2*(Settings!$C$9^2+Settings!$C$8^2))/Bonferroni","v":{"$error":"#DIV/0!"}},{"$f":"IF(OR($Q24<$L24,$Q24>$P24),2,IF(OR($Q24<$M24,$Q24>$O24),1,0))","v":{"$error":"#DIV/0!"}},null,null,null,null,0,0,0,1.96,3.29,{"$f":"F24","v":{"$error":"#DIV/0!"}}]
["Plasma 3",null,null,{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$f":"ABS($C25-$B25)/2/SQRT(2*$D25+$D25^2*2*(Settings!$C$9^2+Settings!$C$8^2))/Bonferroni","v":{"$error":"#DIV/0!"}},{"$f":"IF(OR($Q25<$L25,$Q25>$P25),2,IF(OR($Q25<$M25,$Q25>$O25),1,0))","v":{"$error":"#DIV/0!"}},null,null,null,null,0,0,0,1.96,3.29,{"$f":"F25","v":{"$error":"#DIV/0!"}}]
[]
["Counts at To from graph",null,null,{"$f":"O37","v":{"$error":"#VALUE!"}},null,null,null,{"$f":"IF(OR($Q28<$L28,$Q28>$P28),2,IF(OR($Q28<$M28,$Q28>$O28),1,0))","v":{"$error":"#DIV/0!"}},"Counter-Activity Ratio",null,null,0,0,0,1.96,2.58,{"$f":"ABS(I28-HLOOKUP(Site,Settings!C13:D15,2))/HLOOKUP(Site,Settings!C13:D15,3)","v":{"$error":"#DIV/0!"}}]
["Time of T 1/2 from graph (min)",null,null,{"$f":"LN(1/2)/M35","v":{"$error":"#VALUE!"}},null,null,null,null,{"$f":"D22/(E11*EXP(-LN(2)/6.01*(C17-C13+IF(nextDay,1,0))*24))","v":{"$error":"#DIV/0!"}},"cts/kBq of std.",null,-0.15,-0.1,0,0.1,0.15,{"$f":"I29","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,null,null,null,{"$f":"I28/HLOOKUP(F5,Settings!C13:D14,2,FALSE)-1","v":{"$error":"#DIV/0!"}},"Deviation"]
["GFR (mL/min) =",null,{"$f":"_xlfn.CONCAT(\"Std counts x \", _xlfn.NUMBERVALUE(Settings!C4), \" mL x ln(2) x patient dose (kBq)\")","v":"Std counts x 500 mL x ln(2) x patient dose (kBq)"},null,null,null,null,{"$f":"IF(OR($Q30<$L30,$Q30>$P30),2,IF(OR($Q30<$M30,$Q30>$O30),1,0))","v":{"$error":"#VALUE!"}},"Curve fit",null,null,0.9,0.95,1,1,1,{"$f":"I31","v":{"$error":"#VALUE!"}}]
[null,null,"Plasma cts at To x T1/2 x std dose (kBq)",null,null,null,null,null,{"$f":"INDEX(LINEST(LN(D23:D25),D14:D16,TRUE,TRUE),3)","v":{"$error":"#VALUE!"}},"r²"]
[]
["Corrected GFR (mL/min/1.73 m2) =",null,null,"GFR x 1.73 / BSA"]
[null,null,null,null,null,null,null,null,null,null,null,"Exponential Regression Plot"]
[null,null,null,null,null,null,null,null,null,null,null,"Slope (-Lambdah)",{"$f":"INDEX(LINEST(LN(D23:D25),D14:D16),1)","v":{"$error":"#VALUE!"}}]
[null,null,null,null,null,null,null,null,null,null,null,null,"Time",null,"Counts","Normalized counts"]
[null,null,null,null,null,null,null,null,null,null,null,"Y intercept",0,null,{"$f":"EXP(INDEX(LINEST(LN(D23:D25),D14:D16),2))","v":{"$error":"#VALUE!"}},{"$f":"O37/$O$37","v":{"$error":"#VALUE!"}}]
[null,null,null,null,null,null,null,null,null,null,null,"End time",320,null,{"$f":"  O37*EXP(M35*M38)","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"}]
[null,null,null,null,null,null,null,null,null,null,null,"50% intercept",{"$f":" LN(1/2)/M35","v":{"$error":"#VALUE!"}},null,{"$f":" O37*EXP(M35*D28)","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"}]
[null,null,null,null,null,null,null,null,null,null,null,"50% intercept top",{"$f":" LN(1/2)/M35","v":{"$error":"#VALUE!"}},null,{"$f":"O37","v":{"$error":"#VALUE!"}},{"$error":"#VALUE!"}]
[null,null,null,null,null,null,null,null,null,null,null,"Plasma 1",{"$f":"D14","v":0},null,{"$f":"D23","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"}]
[null,null,null,null,null,null,null,null,null,null,null,"Plasma 2",{"$f":"D15","v":0},null,{"$f":"D24","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"}]
[null,null,null,null,null,null,null,null,null,null,null,"Plasma 3",{"$f":"D16","v":0},null,{"$f":"D25","v":{"$error":"#DIV/0!"}},{"$error":"#DIV/0!"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"GFR",{"$f":"D22*Settings!C4*LN(2)*C11/(D27*D28*E11)","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,null,null,null,null,null,null,"BSA corrected GFR",{"$f":"GFR*1.73/F4","v":{"$error":"#DIV/0!"}}]
[null,null,null,null,null,null,null,null,null,null,null,"BM & BSA corrected GFR",{"$f":"1.0004*BSA_corrected_GFR-0.00146*BSA_corrected_GFR^2","v":{"$error":"#DIV/0!"}}]
[]
[null,null,null,null,null,null,null,null,null,null,null,"Revisions"]
[null,null,null,null,null,null,null,null,null,null,null,"2018-05-02","Template as supplemental material in NMC, 2019, 40(1):30-40"]
[null,null,null,null,null,null,null,null,null,null,null,"2019-02-27","Addition of Brochner-Mortensen correction."]
[null,{"$f":"CONCATENATE(\"GFR: \",TEXT(GFR,\"0\"))","v":{"$error":"#DIV/0!"}},"ml/min",{"$f":"MAX(H30,H27,G4:G8,G14:G25,IF(Q9<N9,G9,0),IF(Q10<N10,G10,0))","v":{"$error":"#VALUE!"}},{"$f":"IF(D53=0,\"QC tests passed.\",IF(D53=1,\"QC tests at tolerance.\",\"QA tests failed.\"))","v":{"$error":"#VALUE!"}},null,null,null,"Entered by"]
[null,{"$f":"CONCATENATE(\"BSA Corrected GFR: \",TEXT(BSA_corrected_GFR,\"0\"))","v":{"$error":"#DIV/0!"}},"ml/min/1.73m2",null,{"$f":"IF(D53=0,\"\",IF(D53=1,\"Results may be inaccurate.\",\"Results are likely inaccurate.\"))","v":{"$error":"#VALUE!"}},null,null,null,"Checked by"]
[null,{"$f":"CONCATENATE(\"BM Corrected GFR: \",TEXT(BM_and_BSA_corrected_GFR,\"0\"))","v":{"$error":"#DIV/0!"}},"ml/min/1.73m2",null,null,null,null,null,"Spreadsheet rivision date: 2019-02-27"]
["*BM corrected GFR includes correction for BSA and Brochner-Mortensen corrections for fast exponential using the combined adult and pediatric equation (15) in Fleming JS et al. Nuc Med Comm, 2014;25(8):759–769."]

{"sheet":"Settings","index":2,"n_rows":16,"n_cols":5,"rows_kept":16,"cut":false,"hidden":false,"merged":[]}
[]
[null,"Settings"]
[]
[null,"Standard volume",500,"mL"]
[null,"Pipetting volume",100,"µL"]
[]
[null,"Pipet Accuracy",8.0000000000000002E-3,"From vendor Eppendorf Reference Yellow"]
[null,"Pipet Precision",1.5E-3,"http://www.eppendorf.com/int/index.php?pb=611a137f7fd720bc&action=products&contentid=1&catalognode=9477&productpage=3"]
[null,"Pipeting operator precision",0.01,"Based on pipetting experiement Oct 2015 + 2%"]
[null,"Bonferroni correction",3]
[]
[null,"Counter efficiency"]
[null,"Site","Site 1","Site 2"]
[null,"Mean",9.81,15.25,"cts/kBq"]
[null,"STD",0.21199999999999999,0.56000000000000005,{"$f":"E14","v":"cts/kBq"}]
[null,null,{"$f":"C15/C14","v":2.1610601427115187E-2},{"$f":"D15/D14","v":3.6721311475409843E-2}]