医生办公室的实验室结果是否质量与其他实验室产生的结果相美?
J Hurst1, K Nickel, L H Hilborne
1Laboratory Field Services, California Department of Health Services, Berkeley, USA.
JAMA
|February 18, 1998
概括
与其他临床实验室相比,医生办公室实验室 (POLs) 在熟练测试中失败率明显较高. 这表明POL测试的准确性和可靠性可能存在问题,需要进一步调查和监督.
科学领域:
- 临床实验室科学 临床实验室科学
- 改善医疗保健质量 改善医疗保健质量
- 医学诊断 医学诊断 医学诊断
背景情况:
- 加利福尼亚州在1995年采用与临床实验室改进修正案 (CLIA) 标准一致的实验室法律后,要求进行一项研究,将医生办公室实验室 (POL) 的实验室结果与其他环境进行比较.
- 这项研究旨在评估在POL中进行的测试的准确性和可靠性.
研究的目的:
- 为了确定POL是否产生与非POL设置相比准确和可靠的测试结果.
- 根据测试地点,识别实验室测试质量的潜在差异.
主要方法:
- 一项对临床实验室的调查使用了1996年美国生物分析师协会 (American Association of Bioanalysts) 能力测试计划中的能力测试数据.
- 数据包括参与该计划的所有1110个加利福尼亚州临床实验室.
- 测量结果是"不满意" (一次性失败) 和"失败" (重复失败) 率在熟练测试样本上.
主要成果:
- 医生办公室实验室 (POL) 的"不满意"失败率几乎是非POL的三倍 (21.5%对8.1%).
- 在POL中"失败"的失败率是非POL的四倍以上 (4.4%对0.9%).
- 使用实验室专业人员的POL显示较低,但与非POL相比仍然显著更高的失败率.
结论:
- 在POL,拥有执照的专业人员的POL和非POL之间存在显著的质量差异.
- 许多POL的测试人员可能缺乏足够的教育,培训和监督,导致表现较差.
- 需要进一步的研究来了解POL表现较低背后的因素,患者应该意识到潜在的测试质量变化.
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