Patients as Their Own Controls: Use of the Computer to Identify "Laboratory Error"

1975 ◽  
Vol 21 (11) ◽  
pp. 1648-1653 ◽  
Author(s):  
Jack H Ladenson
Keyword(s):  
Quality Control ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Test Results ◽  
Total Calcium ◽  
Laboratory Error ◽  
Total Thyroxine ◽  
Clinical Chemistry Laboratory ◽  
Check System

Abstract I describe a system of quality control based on computer detection of changes in individual patient test results. This system, called "delta check," was used to follow all the tests performed by the clinical chemistry laboratory in a 1200-bed hospital. Analysis of 22 months’ experience indicates that specimen misidentification is a serious problem in the clinical chemistry laboratory. Over a nine-month period, errors were most frequent in the results for total thyroxine, total calcium, and total protein. Instances of laboratory error detectable by the delta check system are not detected by other currently used methods of quality control. This system therefore appears to be a valuable asset to the clinical laboratory

An evaluation of the detection capacity of a computer-assisted real-time delta check system.

1979 ◽  
Vol 25 (6) ◽  
pp. 870-872 ◽  
Author(s):  
P P Sher
Keyword(s):  
Real Time ◽  
Clinical Condition ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Computer Assisted ◽  
Test Results ◽  
Laboratory Staff ◽  
Laboratory Errors ◽  
Clinical Chemistry Laboratory ◽  
Check System

Abstract We developed of computer programs to evaluate the clinical reliability of test results by comparing each new result with previous results for the same patient, and to signal discrepancies in real time. These "delta check" discrepancies are noted, and they must be reviewed by the laboratory staff before results can appear on a patient's record. During a month, I reviewed 1403 such delta check messages and detected 55 (3.9%) that could not be explained on the basis of the patient's clinical condition. Of these, 23 represented true laboratory errors, which were corrected. The recognition of discrepancies before they appear on patients' reports has facilitated the operation of the clinical chemistry laboratory. Mislabeled and otherwise mishandled specimens are discovered before erroneous results appear on a patient's record.

Comparison of results for 13 clinical laboratory determinations with three automated analytical systems.

1976 ◽  
Vol 22 (3) ◽  
pp. 346-349 ◽  
Author(s):  
E J Sampson ◽  
D D Derck ◽  
L M Demers
Keyword(s):  
Normal Control ◽  
Continuous Flow ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Upper Limits ◽  
Control Serum ◽  
Flow Systems ◽  
Clinical Chemistry Laboratory ◽  
Better Than

Abstract We evaluated the Abbott Bichromatic Analyzer-100 (ABA-100) for use in the routine clinical chemistry laboratory by examining 13 different determinations that can be performed on the instrument. Results with the Du Pont "aca" and Technicon continuous-flow systems were compared to the ABA-100 in terms of upper limits of linearity, inter-run coefficient of variation, and results for samples from patients. The upper limits of linearity for the methods on the ABA-100 exceeded all of those for the continuous-flow systems, except for urea nitrogen. Precision of the ABA-100 was as good as or better than that of the aca for all determinations, except for glucose in a normal control serum and creatine kinase and creatinine in an above-normal control serum.

Automatic Discrete Sample Processing: Automation in a Clinical Chemistry Laboratory Based on Discrete Sample Handling and Computerized Data Processing

1969 ◽  
Vol 15 (7) ◽  
pp. 600-610 ◽  
Author(s):  
George Westlake ◽  
Donald K McKay ◽  
Philip Surh ◽  
David Seligson
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Present Report ◽  
General Purpose ◽  
Electrical Signal ◽  
Chemistry Laboratory ◽  
Sample Handling ◽  
Discrete Sample ◽  
Operational Characteristics ◽  
Clinical Chemistry Laboratory

Abstract It is our belief that a general-purpose digital computer that receives and processes the electrical signal from an analytic instrument to its final step, and then processes the latter to produce a patient report, is an essential tool of the clinical laboratory. The present report concerns the development of a discrete-sample-handling analytic instrument that was designed to interface with a computer. A description is given of the entire system that includes the interface, multiplexing, sample identification, and operational characteristics of the instrument. Some advantages of discrete sample handling in analytic chemistry are accuracy, speed, ease of adaptation to computers, use of small amounts of sample, stepwise analysis of analytic method, and ease of trouble-shooting.

Analytical Bias in a Quality Control Scheme

1969 ◽  
Vol 15 (11) ◽  
pp. 1039-1044 ◽  
Author(s):  
John R Allen ◽  
Rachel Earp ◽  
E Christis Farrell ◽  
H D Grümer
Keyword(s):  
Quality Control ◽  
Clinical Chemistry ◽  
Control Program ◽  
Chemistry Laboratory ◽  
Quality Control Program ◽  
Control Scheme ◽  
Clinical Chemistry Laboratory ◽  
Random Times ◽  
Quality Control Scheme ◽  
Control Samples

Abstract A quality control program utilizing both "known" and "blind" control specimens was analyzed in the routine clinical chemistry laboratory. The results obtained with the control samples of 18 automated and nonautomated procedures demonstrated the presence of analytical bias. Only through the evaluation of blind control samples tested at random times can a reliable measure of the proficiency of the laboratory be achieved.

scholarly journals MODULARANALYTICS: A New Approach to Automation in the Clinical Laboratory

2005 ◽  
Vol 2005 (1) ◽  
pp. 8-25 ◽  
Author(s):  
Gary L. Horowitz ◽  
Zahur Zaman ◽  
Norbert J. C. Blanckaert ◽  
Daniel W. Chan ◽  
Jeffrey A. Dubois ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Control Unit ◽  
Turnaround Time ◽  
Chemistry Laboratory ◽  
New Approach ◽  
Typical Sample ◽  
Clinical Chemistry Laboratory ◽  
Carry Over ◽  
Roche Diagnostics

MODULARANALYTICS(Roche Diagnostics) (MODULARANALYTICS, Elecsys and Cobas Integra are trademarks of a member of the Roche Group) represents a new approach to automation for the clinical chemistry laboratory. It consists of a control unit, a core unit with a bidirectional multitrack rack transportation system, and three distinct kinds of analytical modules: an ISE module, a P800 module (44 photometric tests, throughput of up to 800 tests/h), and a D2400 module (16 photometric tests, throughput up to 2400 tests/h). MODULARANALYTICSallows customised configurations for various laboratory workloads. The performance and practicability of MODULARANALYTICSwere evaluated in an international multicentre study at 16 sites. Studies included precision, accuracy, analytical range, carry-over, and workflow assessment. More than 700 000 results were obtained during the course of the study. Median between-day CVs were typically less than 3% for clinical chemistries and less than 6% for homogeneous immunoassays. Median recoveries for nearly all standardised reference materials were within 5% of assigned values. Method comparisons versus current existing routine instrumentation were clinically acceptable in all cases. During the workflow studies, the work from three to four single workstations was transferred to MODULARANALYTICS, which offered over 100 possible methods, with reduction in sample splitting, handling errors, and turnaround time. Typical sample processing time on MODULARANALYTICSwas less than 30 minutes, an improvement from the current laboratory systems. By combining multiple analytic units in flexible ways, MODULARANALYTICSmet diverse laboratory needs and offered improvement in workflow over current laboratory situations. It increased overall efficiency while maintaining (or improving) quality.

Calorimetry, a time-honored technique with a potential in analytical work and cellular biology.

1977 ◽  
Vol 23 (6) ◽  
pp. 929-937 ◽  
Author(s):  
K Levin
Keyword(s):  
Human Blood ◽  
Blood Cells ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Human Blood Cells ◽  
Analytical Work ◽  
Other Substances ◽  
Clinical Chemistry Laboratory ◽  
Analytical Tools

Abstract Different types of calorimeters are briefly reviewed, stressing those instruments likely to be of interest in the clinical chemistry laboratory. The unspecific nature of the measuring procedure is emphasized and various pitfalls likely to cause analytical errors are pointed out. Recent work is reviewed where calorimeters have been used as analytical tools for the determination of glucose, protein, enzymes, and other substances. The results generally compared favorably with those obtained by conventional analytical procedures. In recent reports the time per analysis has been brought down to 2 min, with sample volumes in the micro range. Valuable information on the coagulation process has been obtained by use of calorimetry. I also review studies showing that intact cellular elements such as human blood cells, bacteria, and spermatozoa can successfully be investigated with calorimetric techniques. In particular, studies on human blood cells stimulated with various agents appear to be able to give valuable diagnostic information. I believe that new designs of microcalorimeters have placed an easily handled tool at the disposal of the worker in a clinical laboratory and that use of this tool can contribute to the development of our discipline.

The Gallium Melting-Point Standard: Its Role in Manufacture and Quality Control of Electronic Thermometers for the Clinical Laboratory

1977 ◽  
Vol 23 (4) ◽  
pp. 725-732 ◽  
Author(s):  
Henry E Sostman
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Temperature Sensors ◽  
Chemistry Laboratory ◽  
National Bureau ◽  
Clinical Chemistry Laboratory ◽  
A Cell ◽  
Basic Standards ◽  
Constants Of Nature ◽  
Gallium Melting Point

Abstract I discuss the traceability of calibration of electronic ther-mometers to thermometric constants of nature or to the National Bureau of Standards, from a manufacturer's basic standards through the manufacturing process to the user's laboratory. Useful electrical temperature sensors, their advantages, and means for resolving their disadvantages are described. I summarize our development of a cell for realizing the melting phase equilibrium of pure gallium (at 29.770 °C) as a thermometer calibration fixed point, and enumerate its advantages in the routine calibration veri-fication of electrical thermometers in the clinical chemistry laboratory.

scholarly journals Application of sigma metrics for the assessment of quality control in clinical chemistry laboratory in Ghana: A pilot study

2015 ◽  
Vol 56 (1) ◽  
pp. 54 ◽  
Author(s):  
Justice Afrifa ◽  
SethA Gyekye ◽  
WilliamKBA Owiredu ◽  
RichardKD Ephraim ◽  
Samuel Essien-Baidoo ◽  
...  
Keyword(s):  
Quality Control ◽  
Pilot Study ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Clinical Chemistry Laboratory
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