Favaloro Emmanuel J, Lippi Giuseppe, Adcock Dorothy M
Department of Haematology, ICPMR, Westmead Hospital, Westmead, Australia.
Semin Thromb Hemost. 2008 Oct;34(7):612-34. doi: 10.1055/s-0028-1104540. Epub 2008 Dec 15.
The advent of modern instrumentation, with associated improvements in test reliability, together with appropriate internal quality control and external quality assurance measures, has led to substantial reduction in analytical errors within hemostasis laboratories. Unfortunately, the reporting of incorrect or inappropriate test results still occurs, perhaps even as frequently as in the past. Many of these cases will arise due to a variety of events largely outside the control of the laboratories performing the laboratory tests and primarily comprise preanalytical events related to patient collection and sample processing and postanalytical events related to the reporting and interpretation of test results. The current article provides an overview of these events and provides some suggestions on how they can be minimized or prevented to ensure that the test results the clinician receives actually represent the true clinical status of the patient under investigation rather than just reflecting the status of an (inappropriate) clinical sample received and tested. This article should be of interest to both laboratory scientists working in hemostasis and the clinicians that request such tests. The former, because these are ultimately responsible for the test results they provide to clinicians, and there is a duty of care to provide both accurate and precise results to enable clinicians to manage patients appropriately and to avoid the need to recollect and retest. The latter because unless clinicians gain an appreciation of these issues, they will not be in a position to best manage their patients.
现代检测仪器的出现，以及检测可靠性的相关提高，再加上适当的内部质量控制和外部质量保证措施，已使止血实验室的分析误差大幅减少。不幸的是，不正确或不恰当检测结果的报告仍时有发生，甚至可能与过去一样频繁。许多此类情况是由各种很大程度上超出进行实验室检测的实验室控制范围的事件引起的，主要包括与患者采血和样本处理相关的分析前事件以及与检测结果报告和解释相关的分析后事件。本文概述了这些事件，并就如何将其最小化或预防提供了一些建议，以确保临床医生收到的检测结果实际代表所调查患者的真实临床状况，而不仅仅反映所接收和检测的（不恰当）临床样本的状况。本文对于从事止血工作的实验室科学家和要求进行此类检测的临床医生都应具有参考价值。对于前者而言，因为他们最终要对向临床医生提供的检测结果负责，有责任提供准确和精确的结果，以使临床医生能够恰当地管理患者并避免重新采血和重新检测的需要。对于后者而言，因为除非临床医生了解这些问题，否则他们将无法最佳地管理患者。
