Desirable standards for laboratory tests if they are to fulfill medical needs

1993 ◽  
Vol 39 (7) ◽  
pp. 1447-1455 ◽  
Author(s):  
C G Fraser ◽  
P H Petersen
Keyword(s):  
Laboratory Tests ◽  
Normal Values ◽  
Performance Standards ◽  
Biological Variation ◽  
Test Results ◽  
Medical Needs ◽  
Advantages And Disadvantages ◽  
Clinical Vignettes ◽  
Traditional Approaches ◽  
Test Result

Abstract Many strategies to define desirable standards for laboratory tests to fulfill medical needs have been proposed over the last three decades. Traditional approaches are based on reference (normal) values, opinions of clinicians, the state of the art, views of experts, data on biological variation, and assessment of the effect of error on clinical use. All these approaches have advantages and disadvantages, but the consensus of experts reached over a decade ago that imprecision desirably be less than one-half of the within-subject biological variation still seems to provide the best set of generally applicable performance standards. Desirable bias is less than one-quarter of the group (within-subject plus between-subject) biological variation. Recent proposals are either restatements of traditional recommendations, further empirical suggestions, or models based on assessment of clinical needs, and have not been widely accepted. Both old and new studies on clinical opinions, sought by using structured questionnaires containing clinical vignettes designed to seek views on the magnitude of significant change, are flawed in design, execution, and data analysis. Until clinicians are more aware of test-result variability and clinical chemists gain quantitative knowledge on the interpretation of test results, it will be difficult to set desirable standards that fulfill actual medical needs, except in a few well-defined screening situations.

Interpreting clinical and laboratory tests: importance and implications of context

Diagnosis ◽  
2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Alan N. Charney ◽  
Jordan T. Dourmashkin
Keyword(s):  
Laboratory Tests ◽  
Physiological Condition ◽  
Clinical Medicine ◽  
Normal Values ◽  
Reference Interval ◽  
Reference Intervals ◽  
Test Results ◽  
Normal Range ◽  
Behavioral Diversity ◽  
Range Test

AbstractClinical and laboratory tests in clinical medicine include a range of measurements that may be categorized as “normal range” tests, positive or negative tests, or contextual tests. Normal range test results are quantitative and are compared to a reference interval or range provided by the laboratory. Positive or negative tests are also quantitative tests and characteristically have a cutoff value that specifies the result. Contextual tests require a context, a physiological condition, to correctly interpret the result. A closer examination of reference intervals suggests that these also are contextual. The fact that there is a range of apparently normal values indicates the presence of cultural, biological, physiological and behavioral diversity in the population sampled to determine normality. As such, the reference interval describes the population from which it was determined and may have utility in this regard.

scholarly journals Assessment of laboratory tests and test results using data on biological variation

1996 ◽  
Vol 18 (sup1) ◽  
pp. 54-55
Author(s):  
A.L. Jensen ◽  
R. Hoier ◽  
L. Iversen
Keyword(s):  
Laboratory Tests ◽  
Biological Variation ◽  
Test Results ◽  
Using Data

Item Context and /s/ Phone Articulation Test Results

1972 ◽  
Vol 15 (4) ◽  
pp. 852-860 ◽  
Author(s):  
Zoe Zehel ◽  
Ralph L. Shelton ◽  
William B. Arndt ◽  
Virginia Wright ◽  
Mary Elbert
Keyword(s):  
Test Score ◽  
Sound Production ◽  
Broad Context ◽  
Test Results ◽  
Production Task ◽  
Test Result

Fourteen children who misarticulated some phones of the /s/ phoneme were tape recorded articulating several lists of items involving /s/. The lists included the Mc-Donald Deep Test for /s/, three lists similar to McDonald’s but altered in broad context, and an /s/ sound production task. Scores from lists were correlated, compared for differences in means, or both. Item sets determined by immediate context were also compared for differences between means. All lists were found to be significantly correlated. The comparison of means indicated that both broad and immediate context were related to test result. The estimated “omega square” statistic was used to evaluate the percentage of test score variance attributable to context.

Voltage Phase Difference Detection for Superconductor Quench

2014 ◽  
Vol 933 ◽  
pp. 82-85
Author(s):  
Shi Feng Wang ◽  
Yi Xiang Yue ◽  
Jin Fang
Keyword(s):  
Phase Difference ◽  
Detection Method ◽  
Phase Detection ◽  
Test Results ◽  
Development Platform ◽  
Advantages And Disadvantages ◽  
Difference Detection ◽  
Protection Systems ◽  
Actual Operation ◽  
Voltage Phase

In this paper, the actual operation of the superconducting motor and electrical parameters, a detailed analysis of the advantages and disadvantages of the existing quench detection method. After that I proposed an innovative detection method - voltage phase difference detection. On this basis, the design phase detection method based on the voltage difference quench detection and protection systems, based on stand-alone test and NI development platform test results, we verify its feasibility of the voltage phase difference detection method, and great superiority.

scholarly journals Influenza colloidal gold method and blood routine tests combination for rapid diagnosis of influenza: a decision tree-based analysis

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Xiaoguang Li ◽  
Jing Chen ◽  
Fei Lin ◽  
Wei Wang ◽  
Jie Xu ◽  
...  
Keyword(s):  
Decision Tree ◽  
Predictive Value ◽  
Colloidal Gold ◽  
Influenza A ◽  
Clinical Manifestations ◽  
Rapid Test ◽  
Test Results ◽  
Tree Model ◽  
Routine Blood ◽  
Test Result

AbstractRapid influenza diagnosis can facilitate targeted treatment and reduce antibiotic misuse. However, diagnosis efficacy remains unclear. This study examined the efficacy of a colloidal gold rapid test for rapid influenza diagnosis. Clinical characteristics of 520 patients with influenza-like illness presenting at a fever outpatient clinic during two influenza seasons (2017–2018; 2018–2019) were evaluated. The clinical manifestations and results of routine blood, colloidal gold, and nucleic acid tests were used to construct a decision tree with three layers, nine nodes, and five terminal nodes. The combined positive predictive value of a positive colloidal gold test result and monocyte level within 10.95–12.55% was 88.2%. The combined negative predictive value of a negative colloidal gold test result and white blood cell count > 9.075 × 109/L was 84.9%. The decision-tree model showed the satisfactory accuracy of an early influenza diagnosis based on colloidal gold and routine blood test results.

Predicting abnormal laboratory blood test results in the intensive care unit using novel features based on information theory and historical conditional probability (Preprint)

2021 ◽  
Author(s):  
Camilo E. Valderrama ◽  
Daniel J. Niven ◽  
Henry T. Stelfox ◽  
Joon Lee
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Conditional Probability ◽  
Blood Test ◽  
Laboratory Tests ◽  
Conditional Entropy ◽  
Admission Diagnosis ◽  
Test Results ◽  
Abnormal Laboratory ◽  
Blood Tests

BACKGROUND Redundancy in laboratory blood tests is common in intensive care units (ICU), affecting patients' health and increasing healthcare expenses. Medical communities have made recommendations to order laboratory tests more judiciously. Wise selection can rely on modern data-driven approaches that have been shown to help identify redundant laboratory blood tests in ICUs. However, most of these works have been developed for highly selected clinical conditions such as gastrointestinal bleeding. Moreover, features based on conditional entropy and conditional probability distribution have not been used to inform the need for performing a new test. OBJECTIVE We aimed to address the limitations of previous works by adapting conditional entropy and conditional probability to extract features to predict abnormal laboratory blood test results. METHODS We used an ICU dataset collected across Alberta, Canada which included 55,689 ICU admissions from 48,672 patients with different diagnoses. We investigated conditional entropy and conditional probability-based features by comparing the performances of two machine learning approaches to predict normal and abnormal results for 18 blood laboratory tests. Approach 1 used patients' vitals, age, sex, admission diagnosis, and other laboratory blood test results as features. Approach 2 used the same features plus the new conditional entropy and conditional probability-based features. RESULTS Across the 18 blood laboratory tests, both Approach 1 and Approach 2 achieved a median F1-score, AUC, precision-recall AUC, and Gmean above 80%. We found that the inclusion of the new features statistically significantly improved the capacity to predict abnormal laboratory blood test results in between ten and fifteen laboratory blood tests depending on the machine learning model. CONCLUSIONS Our novel approach with promising prediction results can help reduce over-testing in ICUs, as well as risks for patients and healthcare systems. CLINICALTRIAL N/A

Patient recommendations for content and design for electronic return of genetic test results: An interview study among patients who accessed their genetic test results online (Preprint)

2021 ◽  
Author(s):  
Diane M Korngiebel ◽  
Kathleen McGlone West
Keyword(s):  
Patient Preferences ◽  
Genetic Test ◽  
Smartphone Application ◽  
Patient Portal ◽  
Genetic Test Result ◽  
Test Results ◽  
User Centered Design ◽  
Detailed Report ◽  
Genetic Test Results ◽  
Test Result

BACKGROUND Genetic test results will be increasingly made available electronically as more patient-facing tools are developed; however, little research has been done that collects patient preferences for content and design before creating results templates. OBJECTIVE This study identifies patient preferences for electronic return of genetic test results, including what considerations should be prioritized for content and design. METHODS Following User-Centered Design methods, 59 interviews were conducted using semi-structured protocols. The interviews explored content and design issues for patient portal results return for patients who received electronic results for specific types of genetic tests (pharmacogenomic, hereditary blood disorders, and positive and negative risk results for heritable cancers) or who had electronically received any type of genetic test result as well as a non-genetic test result. RESULTS In general, a majority of participants felt that there always needed to be some clinician involvement in electronic results return and that electronic coversheets with simple summaries would be helpful for facilitating that. Coversheet summaries could accompany, but not replace, the more detailed report. Participants had specific suggestions for those results summaries, such as only reporting the information that was most important for patients to understand, including next steps, and to do so using clear language free of medical jargon. Electronic results return should also include explicit encouragement for patients to contact providers with questions. Finally, many participants preferred to manage their care using their smartphones, particularly in instances where they needed to access health information on the go. CONCLUSIONS Participants recommended that a patient-friendly front section accompany the more detailed report and made suggestions for organization, content, and wording. Many used their smartphones regularly to access test results, therefore, health systems and patient portal software vendors should accommodate smartphone application design and web portal design concomitantly when developing results return platforms. CLINICALTRIAL N/A

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek
Keyword(s):  
Polymerase Chain Reaction ◽  
Death Anxiety ◽  
Short Form ◽  
Anxiety Score ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Test Result ◽  
Pcr Test

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

Theoretical Calculation and Experimental Research on Sequential Turbocharging of a Marine Diesel Engine

2011 ◽  
Vol 305 ◽  
pp. 416-422
Author(s):  
Peng Qi Zhang ◽  
Qing Lin He ◽  
Yin Yan Wang
Keyword(s):  
Diesel Engine ◽  
Theoretical Calculation ◽  
Experimental Research ◽  
Marine Diesel Engine ◽  
Test Results ◽  
Low Load ◽  
Marine Diesel ◽  
Working Principle ◽  
Test Result

The paper introduces the working principle of the sequential turbo-charging (STC) system of multi-turbocharger. To improve low-load performance and operating economy of the 234V12 diesel engine, a STC system of multi-turbocharger for the diesel engine was designed. Theoretical calculation and experimental research was done on this improved marine diesel engine. Then, a 3-phase STC system is presented by analyzing and comparing the test result and the switching boundary of this system is confirmed. The test results show that the low-load performance is improved obviously by use of multi-turbocharger STC system.

scholarly journals Utilisation of laboratory test results for patient management by clinicians at two large referral hospitals in Zambia

2020 ◽  
Author(s):  
Sabe Mwape ◽  
Victor Daka ◽  
Scott Matafwali ◽  
Kapambwe Mwape ◽  
Jay Sikalima ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
Medical Laboratory ◽  
Test Results ◽  
Cross Sectional ◽  
Childrens Hospital ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Referral Hospitals

Background Medical laboratory diagnosis is a critical component of patient management in the healthcare setup. Despite the availability of laboratory tests, clinicians may not utilise them to make clinical decisions. We investigated utilsation of laboratory tests for patient management among clinicians at Ndola Teaching Hospital (NTH) and Arthur Davison Childrens Hospital (ADCH), two large referral hospitals in the Copperbelt Province, Ndola, Zambia. Method We conducted a descriptive cross-sectional study among clinicians. The study deployed self-administered questionnaires to evaluate clinician utilisation, querying and confidence in laboratory results. Additional data on demographics and possible laboratory improvements were also obtained. Data were entered in Microsoft excel and exported to SPSS version 16 for statistical analysis. Results Of the 80 clinicians interviewed, 96.2% (77) reported using laboratory tests and their results in patient management. 77.5% (62) of the clinicians indicated they always used laboratory results to influence their patient management decisions. Of the selected laboratory tests, clinicians were more confident in using haemoglobin test results (91.2%). There was no statistically significant association between the clinicians gender or qualification and use of test results in patient management. Conclusion Our findings show that despite the majority querying laboratory results, most of the clinicians use laboratory results for patient management. There is need for interactions between the laboratory and clinical area to assure clinician confidence in laboratory results. Key words: utilisation, clinicians, laboratory tests, Ndola Teaching Hospital, Arthur Davison Childrens Hospital

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