From conventional to personalized reference intervals and decision limits: addressing latent errors in the post-post...

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Medical Error Analysis

Background:

• Laboratory errors contribute significantly to overall medical errors, particularly in extra-analytical testing phases.
• The post-post-analytical phase, involving clinical interpretation of lab data, is prone to errors due to reliance on population-based references.

Purpose of the Study:

• To summarize the limitations of current population-based reference intervals (popRIs) and decision limits (popDLs).
• To introduce and develop the concept of latent errors in laboratory data interpretation.
• To advocate for the implementation of personalized reference intervals (prRIs) and decision limits (prDLs) to enhance patient safety.

Main Methods:

• Conceptual analysis of limitations in population-based references.
• Development of the 'latent error' concept in the context of clinical interpretation.
• Discussion of personalized references as a solution to reduce interpretation errors.

Main Results:

• Population-based references (popRIs, popDLs) have inherent limitations leading to systematic, latent errors.
• Personalized references (prRIs, prDLs) offer a more accurate approach for data interpretation.
• The discrepancy between population-based and personalized references can compromise patient safety.

Conclusions:

• Personalized reference intervals and decision limits are crucial for minimizing latent errors in the post-post-analytical phase.
• Implementing personalized references can significantly improve the accuracy of patient laboratory data interpretation.
• Adoption of personalized references is essential for advancing patient safety in clinical practice.