Chung Michael C, Gombar Saurabh, Shi Run Zhang
Stanford Health Care, 300 Pasteur Drive, Palo Alto, CA 94304, USA.
Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA.
J Pathol Inform. 2017 Jul 25;8:28. doi: 10.4103/jpi.jpi_28_17. eCollection 2017.
Automated calculations by laboratory information system (LIS) are efficient and accurate ways of providing calculated laboratory test results. Due to the lack of established advanced mathematical functions and equation logic in LIS software, calculations beyond simple arithmetic functions require a tedious workaround. Free and bioavailable testosterone (BT) calculations require a quadratic solver currently unavailable as ready to use the function on most commercial LIS platforms. We aimed to develop a module within the Epic Beaker LIS to enable automatic quadratic equation solving capability and real-time reporting of calculated free and BT values.
We developed and implemented an advanced calculation module from the ground up using existing basic calculation programming functions in the Epic Beaker LIS. A set of calculation variables were created, and mathematical logic and functions were used to link the variables and perform the actual quadratic equation based calculations. Calculations were performed in real-time during result entry events, and calculated results populated the result components in LIS automatically.
Free and BT were calculated using instrument measured results of total testosterone, sex hormone binding globulin, and/or serum albumin, by applying equations widely adopted in laboratory medicine for endocrine diseases and disorders. Calculated results in Epic Beaker LIS were then compared and confirmed by manual calculations using Microsoft Excel spreadsheets and scientific calculators to have no discrepancies.
Automated calculations of free and BT were successfully implemented and validated, the first of such implementation for the Epic Beaker LIS platform, eliminating the need of offline manual calculations, potential transcription error, and with improved turnaround time. It may serve as a model to build similarly complex equations when the clinical need arises.
实验室信息系统（LIS）进行的自动计算是提供计算得出的实验室检测结果的高效且准确的方式。由于LIS软件缺乏既定的高级数学函数和方程逻辑，超出简单算术函数的计算需要繁琐的变通方法。游离睾酮和生物可利用睾酮（BT）的计算需要一个二次方程求解器，而目前在大多数商业LIS平台上无法直接使用该功能。我们旨在开发一个Epic Beaker LIS模块，以实现二次方程的自动求解能力，并实时报告计算得出的游离睾酮和BT值。
我们利用Epic Beaker LIS中现有的基本计算编程函数，从头开始开发并实施了一个高级计算模块。创建了一组计算变量，并使用数学逻辑和函数将这些变量链接起来，进行基于实际二次方程的计算。在结果录入事件期间实时进行计算，计算结果会自动填充到LIS的结果组件中。
通过应用内分泌疾病和紊乱的实验室医学中广泛采用的方程，使用仪器测量的总睾酮、性激素结合球蛋白和/或血清白蛋白结果来计算游离睾酮和BT。然后，使用Microsoft Excel电子表格和科学计算器进行手动计算，对Epic Beaker LIS中的计算结果进行比较和确认，结果无差异。
游离睾酮和BT的自动计算已成功实现并得到验证，这是Epic Beaker LIS平台的首次此类实施，无需进行离线手动计算，避免了潜在的转录错误，并缩短了周转时间。当临床有需要时，它可作为构建类似复杂方程的模型。
