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[临床实验室测量技术的协调方法]

[The ways of harmonization of clinical laboratory measurement techniques].

作者信息

Miller W G, Myers G L, Gantzer M L, Kahn S E, Schönbrunner E R, Thienpont L M, Bunk D M, Christenson R H, Eckfeldt J H, Stanley G L, Nubling C M, Sturgeon C M

出版信息

Klin Lab Diagn. 2013 Feb(2):54-61.

Abstract

The results of implementation of different clinical laboratory techniques are to be equal in clinically significant limits to be optimally applied in diagnostics of diseases and treatment of patients. When the results of laboratory tests are not standardized and harmonized for the very same clinical assay the results can be expressed by unmatched numbers. Unfortunately, in some handbooks the values are presented based on the results of application of specific laboratory techniques without considering possibility or likelihood of differences between various techniques. When this is a case, accumulation of data of diferent clinical research studies and working out of clinical handbooks on this basis will be inconsistent. Inadequate understanding of issue that the results of laboratory tests are not standardized and harmonized can lead to incorrect clinical, financial, managerial or technical decisions. The standardization of clinical laboratory techniques was applied to many measurands related to primary referent techniques (standard specimen of pure substance) or/and developed referent measurement techniques. However, harmonization of clinical laboratory techniques for those measurands which are not related any developed measurement techniques is quite problematic due to inadequate determination of measurand, its inadequate analytical specificity, insufficient attention to commutability of referent materials and poor systematic approach to harmonization. To overcome these issues an infrastructure is to be developed to support systematic approach to identification and prioritization of measurands which are to be harmonized on the basis of clinical importance and technical applicability. The management of technical implementation harmonization process for specific measurands.

摘要

不同临床实验室技术的实施结果应在具有临床意义的范围内保持一致,以便在疾病诊断和患者治疗中得到最佳应用。当针对同一临床检测项目的实验室检测结果未进行标准化和统一时,结果可能会以不匹配的数值呈现。不幸的是,在一些手册中,所呈现的值是基于特定实验室技术的应用结果,而没有考虑不同技术之间存在差异的可能性或概率。在这种情况下,不同临床研究的数据积累以及在此基础上制定临床手册将是不一致的。对实验室检测结果未进行标准化和统一这一问题的认识不足,可能导致错误的临床、财务、管理或技术决策。临床实验室技术的标准化已应用于许多与主要参考技术(纯物质标准样本)相关的被测量物或/和已开发的参考测量技术。然而,对于那些与任何已开发测量技术均无关的被测量物,由于被测量物的确定不充分、其分析特异性不足、对参考物质互换性的关注不够以及统一的系统方法欠佳,临床实验室技术的统一存在很大问题。为克服这些问题,需要建立一个基础设施,以支持基于临床重要性和技术适用性对要统一的被测量物进行识别和优先级排序的系统方法。对特定被测量物技术实施统一过程的管理。

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