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对用于检测不规则分析错误的重复测试实践的评估
Alastair D Green1, Graham R Lee1
1Department of Clinical Biochemistry and Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland.
Clinical chemistry and laboratory medicine
|November 9, 2023
概括
重复测试有效地识别了实验室错误,特别是对高灵敏性心脏-热素-I (hs-cTnI) 和 (Ca2+) 的重复测试. 这种方法通过标记关键错误来防止患者管理不当,尽管成本因测试而异.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 诊断的准确性 诊断的准确性
背景情况:
- 实验室测试中的分析错误可能导致患者管理不善.
- 重复测试是一种用于检测和纠正此类错误的策略.
- 重复测试的成本效益在不同的测试中有所不同.
研究的目的:
- 评估重复测试在识别不规则分析错误方面的有用性.
- 评估重复测试对预防患者管理不善的影响.
- 为了确定实施重复测试对特定实验室分析的成本效益比率.
主要方法:
- 实施 (Na+), (Ca2+),性酸酶 (ALP) 和高灵敏性心脏-热素-I (hs-cTnI) 测试的重复测试.
- 根据重复测试差异,确定识别错误结果 ("飞行员") 和关键错误的定义标准.
- 分析了来自多周/整年的数据,以量化错误率和计算相关成本.
主要成果:
- 错误率有显著差异:Na+ (0.03%的飞行员,0.01%的关键),Ca2+ (4.58%的飞行员,0.84%的关键),ALP (0.22%的飞行员,0.01%的关键),hs-cTnI (1.58%的飞行员,0.14%的关键).
- 重复测试使年度成本从1,100欧元 (Na+) 增加到48,000欧元 (hs-cTnI).
- 在所有测试分析品中发现了关键错误,突出显示了对患者有害的潜力.
结论:
- 重复测试是检测和减轻实验室错误的宝贵工具,特别是在容易出现此类问题的测试中.
- 这种做法对于具有最小相关成本的测定和错误结果具有高临床意义的测定是最合理的.
- 重复测试的战略实施可以通过防止由于分析错误导致的管理不善来提高患者的安全.
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