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Factors associated with analytical errors in blood chemistry tests.
Hyunjung Kim1, Soo Jung Lee2, Hanwool Cho2
1Department of Laboratory Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clinical Chemistry and Laboratory Medicine
|May 9, 2026
Summary
Analytical errors in blood chemistry testing vary by analyte. Carbon dioxide and ammonia have high error rates, while others like sodium and chloride are very stable, informing targeted lab quality control.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Medical Diagnostics
Background:
- Laboratory errors in the analytical phase can impact patient care.
- Systematic evaluation of factors contributing to these errors is limited.
- Improving test result accuracy is crucial for reliable diagnostics.
Purpose of the Study:
- To determine the frequency and characteristics of analytical errors in routine blood chemistry.
- To identify specific analytes most prone to laboratory errors.
- To provide insights for enhancing the accuracy of laboratory test results.
Main Methods:
- Retrospective review of 5 years of retest records for 23 blood chemistry parameters.
- Analysis of 18,015,323 total tests, with 58,637 (0.31%) undergoing repeat analysis.
- Comparison of error rates using chi-square tests, with acceptance limits based on CLIA proficiency testing regulations.
Main Results:
- Overall analytical error rate among retested samples was 1.66%.
- Carbon dioxide (19.67%) and ammonia (16.53%) showed the highest error rates.
- Analytes prone to instability (CO2, ammonia) had higher discrepancies; electrolytes measured by ISEs had lower rates than colorimetric methods.
Conclusions:
- Analytical error rates are influenced by assay complexity, analyte concentration, and specimen stability.
- Targeted retesting strategies are more beneficial for low-concentration or methodologically complex assays.
- Implementing analyte-specific monitoring can improve laboratory efficiency and result accuracy.
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