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Randomized trial interpreting sputum quality in a clinical laboratory.
1Department of Pathology, State University of New York, Stony Brook 11794-8691.
Journal of Clinical Microbiology
|December 1, 1987
Summary
Laboratory interpretation of sputum quality significantly improves physician decisions. Providing Gram stain interpretations led to more follow-up specimens, enhancing diagnostic accuracy.
Area of Science:
- Medical Microbiology
- Clinical Pathology
Background:
- The interpretation of microbiologic results by laboratories is debated, with many deferring this to physicians.
- Physician reliance on laboratory data without expert interpretation can impact clinical decision-making.
Purpose of the Study:
- To assess the impact of laboratory-provided sputum quality interpretations on physician decision-making.
- To determine if laboratory interpretation of Gram stain results influences the ordering of repeat sputum specimens.
Main Methods:
- A randomized study involving 301 poor-quality sputum specimens.
- Specimens were divided into two groups: one receiving laboratory interpretation of Gram stain results, the other receiving only raw results.
- Sputum quality was assessed using a modified Bartlett criteria on Gram-stained smears.
Main Results:
- Physicians were significantly more likely to order a second sputum specimen when provided with a laboratory interpretation of the initial Gram stain results (22% vs. 12%, P = 0.025).
- This suggests that laboratory-based interpretation aids physicians in recognizing and acting upon suboptimal specimen quality.
Conclusions:
- Laboratory interpretation of microbiologic results, specifically sputum quality, can enhance physician decision-making.
- Integrating laboratory expertise into the reporting process improves the clinical utility of diagnostic tests.