Ross J W
Department of Pathology and Clinical Laboratories, Kennestone Hospital, Marietta, GA 30060.
Arch Pathol Lab Med. 1988 Apr;112(4):334-9.
This review of the evolution of evaluation criteria in the College of American Pathologists Survey and of theoretical grounds proposed for evaluation criteria explores the complex nature of the evaluation process. Survey professionals balance multiple variables to seek relevant and meaningful evaluations. These include the state of the art, the reliability of target values, the nature of available control materials, the perceived medical "nonusefulness" of the extremes of performance (good or poor), this extent of laboratory services provided, and the availability of scientific data and theory by which clinically relevant criteria of medical usefulness may be established. The evaluation process has consistently sought peer concensus, to stimulate improvement in state of the art, to increase medical usefulness, and to monitor the state of the art. Recent factors that are likely to promote change from peer group evaluation to fixed criteria evaluation are the high degree of proficiency in the state of the art for many analytes, accurate target values, increased knowledge of biologic variation, and the availability of statistical modeling techniques simulating biologic and diagnostic processes as well as analytic processes.
本文回顾了美国病理学家学会调查中评估标准的演变以及为评估标准提出的理论依据，探讨了评估过程的复杂性。调查专业人员平衡多个变量以寻求相关且有意义的评估。这些变量包括当前技术水平、目标值的可靠性、现有对照材料的性质、性能极端情况（好或差）在医学上的“无用性”认知、所提供实验室服务的范围，以及可用于建立医学实用性临床相关标准的科学数据和理论的可用性。评估过程一直寻求同行共识，以推动当前技术水平的提高，增加医学实用性，并监测当前技术水平。近期可能促使从同行群体评估转向固定标准评估的因素包括许多分析物的当前技术水平高度熟练、准确的目标值、对生物变异的认识增加，以及模拟生物和诊断过程以及分析过程的统计建模技术的可用性。
