Massachusetts General Hospital, GRJ235, 55 Fruit Street, Boston, MA 02114, USA.
Clin Chim Acta. 2014 Jan 1;427:188-92. doi: 10.1016/j.cca.2013.09.025. Epub 2013 Sep 27.
Appropriate assimilation of laboratory test results into patient care is enhanced when pathologist interpretations of the laboratory tests are provided for clinicians, and when reflex algorithm testing is utilized. Benefits of algorithms and interpretations include avoidance of misdiagnoses, reducing the number of laboratory tests needed, reducing the number of procedures, transfusions and admissions, shortening the amount of time needed to reach a diagnosis, reducing errors in test ordering, and providing additional information about how the laboratory results might affect other aspects of a patient's care. Providing interpretations can be challenging for pathologists, therefore mechanisms to facilitate the successful implementation of an interpretation service are described. These include algorithm-based testing and interpretation, optimizing laboratory requisitions and/or order-entry systems, proficiency testing programs that assess interpretations and provide constructive feedback, utilization of a collection of interpretive sentences or paragraphs that can be building blocks ("coded comments") for constructing preliminary interpretations, middleware, and pathology resident participation and education. In conclusion, the combination of algorithms and interpretations for laboratory testing has multiple benefits for the medical care for the patient.
当临床医生获得病理学家对实验室检测的解读,并利用反射算法检测时,实验室检测结果就能更好地应用于患者的治疗中。算法和解读的好处包括避免误诊,减少所需的实验室检测数量,减少操作、输血和住院的次数,缩短诊断所需的时间,减少检测医嘱的错误,并提供有关实验室结果如何影响患者治疗其他方面的更多信息。为病理学家提供解读可能具有挑战性,因此描述了促进解读服务成功实施的机制。这些机制包括基于算法的检测和解读、优化实验室申请和/或订单录入系统、评估解读并提供建设性反馈的能力测试计划、使用一组解释性句子或段落作为构建初步解读的构建块(“编码注释”)、中间件以及病理住院医师的参与和教育。总之,实验室检测的算法和解读相结合,可为患者的医疗带来多种益处。