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重新思考重复测试:当分析标准讲述不同的故事时
Özben Özden Işıklar1, Evin Kocatürk1, Zeynep Başoğlu1
1Department of Medical Biochemistry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
Scandinavian journal of clinical and laboratory investigation
|December 24, 2025
概括
在临床化学实验室中不必要的重复测试是常见的,浪费资源. 应用总允许误差 (TEa) 和参考变化值 (RCV) 等分析标准可以帮助减少这些重复,提高效率和患者安全.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 在紧急临床化学中,重复测试是常见的.
- 它的临床必要性往往是不确定的,导致潜在的延迟和资源浪费.
研究的目的:
- 用三个分析标准来评估重复测试的必要性:实验室特定的观察到的允许总误差 (TEa_Obs),基于CLIA的TEa (TEa_CLIA) 和参考变化值 (RCV).
主要方法:
- 对23个分析对象中18736个重复结果对进行了回顾性分析.
- 根据TEa_Obs,TEa_CLIA和RCV,每个对被分类为必要或不必要的.
- 使用科恩的卡帕 (κ) 评估了标准之间的一致性,并将必要与不必要的重复的周转时间 (TAT) 进行了比较.
主要成果:
- TEa_Obs认为86.2%的重复是不必要的,TEa_CLIA为93.7%,RCV为96.7%.
- 标准之间的一致性一般为低至中等 (κ <0.2至>0.8).
- 必要的重复与更长的周转时间有关,具有不同的统计学意义.
结论:
- 分析标准的选择对解释重复测试的必要性和操作结果产生重大影响.
- 在实验室信息系统 (LIS) 中实施结合TEa_Obs,TEa_CLIA和RCV的规则驱动工作流可以减少不必要的重复,稳定TAT并优化资源使用,而不影响患者的安全.
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