Department of Hematology, Institute of Clinical Pathology and Medical Research ICPMR, Westmead Hospital, SWAHS, Westmead, NSW, Australia.
Clin Chem Lab Med. 2010 Mar;48(3):309-21. doi: 10.1515/CCLM.2010.061.
The advent of modern instrumentation, with associated improvements in test performance and reliability, together with appropriate internal quality control (IQC) and external quality assurance (EQA) measures, has led to substantial reductions 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 arise due to a variety of events largely outside the control of the laboratories performing the tests. These events are primarily preanalytical, related to sample collection and processing, but can also include post-analytical events related to the reporting and interpretation of test results. The current report provides an overview of these events, as well as guidance for prevention or minimization. In particular, we propose several strategies for the post-analytical reporting of hemostasis assays, and how this may provide the final opportunity to prevent serious clinical errors in diagnosis. This report should be of interest to both the laboratory scientists working in hemostasis and clinicians that request and attempt to interpret the test results. Laboratory scientists are ultimately responsible for these test results, and there is a duty to provide both accurate and precise results to enable clinicians to manage patients appropriately and to avoid the need to recollect and retest. Also, clinicians will not be in a position to best diagnose and manage their patient unless they gain an appreciation of these issues.
现代仪器的出现，以及测试性能和可靠性的相关改进，加上适当的内部质量控制（IQC）和外部质量保证（EQA）措施，已经导致止血实验室中的分析误差大大减少。不幸的是，不正确或不适当的测试结果的报告仍然存在，甚至可能像过去一样频繁。这些情况中的许多是由于实验室测试之外的各种事件引起的。这些事件主要是与样本采集和处理相关的分析前事件，但也可能包括与测试结果的报告和解释相关的分析后事件。本报告概述了这些事件，并提供了预防或最小化这些事件的指导。特别是，我们提出了几种止血测定分析后的报告策略，以及这如何为预防诊断中的严重临床错误提供最后的机会。本报告应该对从事止血研究的实验室科学家和请求并尝试解释测试结果的临床医生都有兴趣。实验室科学家最终对这些测试结果负责，有责任提供准确和精确的结果，以使临床医生能够适当地管理患者，并避免需要重新采集和测试。此外，除非临床医生了解这些问题，否则他们将无法最好地诊断和管理他们的患者。
