临床决策受不平等的测量结果和不充分的参考间隔的影响
Marith van Schrojenstein Lantman1,2, Miranda van Berkel2, Philip Kuijper3
1Stichting Kwaliteitsbewaking Medische Laboratoria (SKML), Nijmegen, the Netherlands.
Clinical chemistry
|September 17, 2024
概括
在实验室中使用的参考间隔 (RIs) 经常与分析偏差相冲突,导致误解. 协调RI确保在医疗保健设施中一致的患者诊断.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 生物医学分析 医学分析
背景情况:
- 临床决策需要对测量结果与有效极限进行解释.
- 参考间隔 (RIs) 对于区分正常和异常结果至关重要.
- 这项研究评估了在荷兰实验室对肌素,血红蛋白和费里丁的分析偏差考虑RI的适用性.
研究的目的:
- 评估荷兰实验室常用的参考间隔 (RIs) 的适用性.
- 评估分析偏差对实验室结果解释的影响.
- 确定协调的RI对于一致的临床决策的好处.
主要方法:
- 从SKML.ML收集的外部质量评估 (EQA) 数据.
- 收集了标准人口 (55岁女性) 的常用RI.
- 使用例行患者数据建立了协调的RI,并将其与例行RI进行比较,分析分析偏差.
主要成果:
- 实验室报告了与分析偏差和测量程序不一致的各种RI.
- 在偏差极限内的测试性能不能确保正确的RI使用.
- 由于不适当的RI,患者诊断存在结构性误解的可能性.
结论:
- 不一致的RI在临床决策中会造成实验室间不必要的变化.
- 协调的RI促进了医疗机构对结果的统一解释.
- 协调RI可以在可接受的偏差或测量和标准化后实现.
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