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Interpretative comments and reference ranges in EQA programs as a tool for improving laboratory appropriateness and

Laura Sciacovelli1, Lorena Zardo, Sandra Secchiero

  • 1Centro di Ricerca Biomedica, Via Ospedale, 18, Castelfranco Veneto (TV) 31033, Italy. cucrb1@ulssasolo.ven.it

Clinica Chimica Acta; International Journal of Clinical Chemistry
|July 10, 2003
PubMed
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Laboratory interpretation of biochemical markers for heart damage shows consensus on clinical advice but significant variation in reference ranges (RLs). Standardizing RLs and evaluating interpretive comments are crucial for accurate patient health assessment.

Area of Science:

  • Clinical Biochemistry
  • Laboratory Medicine
  • Diagnostic Testing

Background:

  • Laboratory information relies on interpreting test results against reference ranges (RLs) and providing expert consultation.
  • Accurate interpretation is vital for patient care, especially for biochemical markers of myocardial damage.

Purpose of the Study:

  • To investigate factors influencing data-to-information conversion for cardiac biochemical markers.
  • To assess laboratory consensus on interpretative comments and reference ranges (RLs).

Main Methods:

  • A questionnaire and simulated reports were distributed to 94 laboratories.
  • Analysis of 113 medical reports from an External Quality Assessment (EQA) program.
  • Comparison of declared RLs and verification of clinical significance for troponin I and CK-MB.

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Main Results:

  • Few laboratories consistently provide interpretative comments; collaboration with clinicians is common.
  • General consensus exists on interpreting results and recommending further investigations.
  • Significant variation in reference ranges (RLs) was observed across laboratories.

Conclusions:

  • Auditing laboratory interpretation is necessary to ensure good practice and monitor performance.
  • External Quality Assessment (EQA) programs should evaluate interpretative comments and support RL standardization.
  • Laboratory medicine significantly contributes to objective patient health status evaluation.