National Center for Clinical Laboratories/Beijing Engineering Research Medicine, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China.
Clin Chem Lab Med. 2019 May 27;57(6):832-837. doi: 10.1515/cclm-2018-0877.
Background This study aimed to evaluate the ability of comment providers who were responsible for interpreting results in clinical laboratories in China and to improve the quality of interpretative comments. Methods Basic information and interpretative comments for five cases of 1912 routine chemistry External Quality Assessment (EQA) participant laboratories were collected by web-based EQA system in May 2018. EQA organizers assigned scores to each key phrase of comments based on predetermined marking scale and calculated total scores for each participant's answer. Final scores and ranking were calculated according to scores of cases. Finally, we comprehensively analyzed the type of hospital and the professional title of participants. Results In total, 772 clinical laboratories, 1472 participants, from different Chinese provinces submitted interpretative comments. Median scores, interquartile ranges and score ranges of the five cases were 13 (11-15, 1-20), 13 (10-16, 0-20), 15 (12-17, 0-21), 7 (5-9, -2 to 14) and 12 (10-13, -2 to 18). The final scores and ranking of participants that came from tertiary hospitals were higher than those from secondary and other hospitals; however, there were no significant differences (0.774). When grouped by professional title, we found that although no significant variability existed among senior, intermediate, junior and others (0.699), it existed between laboratory physicians and technicians, as the median final scores of the former were higher than the latter. Conclusions Practice and quality of interpretative comments are indeed different among different laboratories and participants in China. Laboratories should train and assess the interpretative ability of personnel. EQA organizers should also improve the scoring method and establish peer assessors team through this survey.
背景 本研究旨在评估负责解释中国临床实验室检测结果的评论员的能力，以提高解释性评论的质量。
方法 2018 年 5 月，通过网络 EQA 系统收集了来自全国 1912 家常规化学室间质评（EQA）参与者实验室的 5 例病例的基本信息和解释性评论。EQA 组织者根据预定的评分标准为每条评论的关键词打分，并计算每位参与者答案的总分。最终得分和排名根据病例得分计算。最后，我们综合分析了参与者所属医院的类型和职称。
结果 共收到来自中国不同省份的 772 家临床实验室、1472 名参与者的解释性评论。5 例病例的中位数、四分位距和评分范围分别为 13（11-15，1-20）、13（10-16，0-20）、15（12-17，0-21）、7（5-9，-2 至 14）和 12（10-13，-2 至 18）。来自三级医院的参与者的最终得分和排名高于来自二级及其他医院的参与者；然而，这两者之间没有显著差异（0.774）。按职称分组时，我们发现尽管高级、中级、初级和其他职称之间没有显著差异（0.699），但检验科医师和技师之间存在差异，前者的最终中位数评分高于后者。
结论 中国不同实验室和参与者的解释性评论实践和质量确实存在差异。实验室应培训和评估人员的解释能力。EQA 组织者还应通过此次调查改进评分方法并建立同行评估员团队。
