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分析后阶段的性能标准。

Performance criteria of the post-analytical phase.

出版信息

Clin Chem Lab Med. 2015 May;53(6):949-58. doi: 10.1515/cclm-2015-0016.

Abstract

Quality in healthcare is ideally at an optimal benchmark, but must be at least above the minimal standards for care. While laboratory quality is ideally judged in clinical terms, laboratory medicine has also used biological variations and state-of-the-art criteria when, as is often the case, clinical outcome studies or clinical consensus are not available. The post-analytical phase involves taking quality technical results and providing the means for clinical interpretation in the report. Reference intervals are commonly used as a basis for data interpretation; however, laboratories vary in the reference intervals they use, even when analysis is similar. Reference intervals may have greater clinical value if they are both optimised to account for physiological individuality, as well as if they are harmonised through professional consensus. Clinical decision limits are generally superior to reference intervals as a basis for interpretation because they address the specific clinical concern in any patient. As well as providing quality data and interpretation, the knowledge of laboratory experts can be used to provide targeted procedural knowledge in a patient report. Most profoundly critically abnormal results should to be acted upon to minimise the risk of mortality. The three steps in quality report interpretation, (i) describing the abnormal data, (ii) interpreting the clinical information within that data and (iii) providing knowledge for clinical follow-up, highlight that the quality of all laboratory testing is reflected in its impact on clinical management and improving patient outcomes.

摘要

医疗质量理想情况下处于最佳基准,但至少必须高于护理的最低标准。虽然实验室质量理想情况下是根据临床标准进行评估的,但在临床结果研究或临床共识不可用时,实验室医学也会使用生物学变异和最新标准。分析后阶段涉及获取质量技术结果,并在报告中提供临床解释的手段。参考区间通常用作数据解释的基础;然而,即使分析相似,实验室之间的参考区间也存在差异。如果参考区间既针对生理个体差异进行了优化,又通过专业共识进行了协调,那么它们将具有更大的临床价值。临床决策限值通常比参考区间更适合作为解释的基础,因为它们针对任何患者的具体临床问题。除了提供质量数据和解释外,实验室专家的知识还可以用于在患者报告中提供有针对性的程序知识。最严重的异常结果应采取行动,以最大程度地降低死亡率。质量报告解释的三个步骤,(i)描述异常数据,(ii)解释数据中的临床信息,(iii)提供临床随访的知识,突出表明所有实验室检测的质量都反映在其对临床管理的影响和改善患者预后上。

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