Lunetzky E S, Cembrowski G S
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia.
Am J Clin Pathol. 1987 Nov;88(5):634-8. doi: 10.1093/ajcp/88.5.634.
The multirule quality control procedure for interpreting Bull's moving averages, proposed by Levy and colleagues (Am J Clin Pathol 1986; 85: 719-721.), has been evaluated by computer simulation with the use of the approach of Cembrowski and Westgard (Am J Clin Pathol 1985; 83: 337-345.). With this procedure, a batch of patient specimens is rejected if either of two criteria are satisfied: (1) the Bull's mean of one of the red blood cell indices is outside its 3% limits, or (2) the average of three consecutive Bull's means is outside its 2% limits. Power function curves were used to summarize the performance of the multirule approach and demonstrated error-detection capabilities that are superior to the more common implementation of Bull's algorithm using 3% limits for single Bull's means. The increased error detection achieved by the multirule procedure allows shifts in hemoglobin and mean corpuscular volume to be more readily detected but also results in the detection of small shifts in red blood cell count. A modified multirule procedure was also tested and was found to be ineffective. The authors recommend the multirule of Levy and colleagues but caution that its use may result in the detection of small shifts in the red blood cell count.
利维及其同事提出的用于解释布尔移动平均值的多规则质量控制程序（《美国临床病理学杂志》1986年；85:719 - 721），已采用琴布罗夫斯基和韦斯特加德的方法（《美国临床病理学杂志》1985年；83:337 - 345）通过计算机模拟进行了评估。采用该程序时，如果满足以下两个标准中的任何一个，一批患者标本将被拒收：（1）红细胞指数之一的布尔均值超出其3%界限，或（2）三个连续布尔均值的平均值超出其2%界限。功效函数曲线用于总结多规则方法的性能，结果表明该方法的误差检测能力优于更常用的使用单个布尔均值3%界限的布尔算法实现方式。多规则程序实现的误差检测能力增强，使得血红蛋白和平均红细胞体积的变化更容易被检测到，但也会检测到红细胞计数的微小变化。还测试了一种改良的多规则程序，发现其无效。作者推荐使用利维及其同事提出的多规则程序，但提醒使用该程序可能会检测到红细胞计数的微小变化。
