Kazmierczak S C, Catrou P G
Department of Pathology and Laboratory Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Arch Pathol Lab Med. 1993 Jul;117(7):714-8.
The preanalytical, analytical, and postanalytical rates of laboratory error have not been studied extensively. We evaluated the preanalytical, analytical, and postanalytical components of laboratory error in 438 consecutive samples submitted to a clinical chemistry laboratory for measurement of creatinine concentrations in plasma. We performed red blood cell antigen determinations to establish patient-sample identity, repeated analysis of creatinine in duplicate to detect analytical error, and tracking of patient specimens from receipt by the laboratory to entry of the laboratory result in the patient's information system record. We found a total error rate of 9.36%. A breakdown of the total error rate into its preanalytical, analytical, and postanalytical components revealed error rates of 0.00%, 8.90%, and 0.46%, respectively. These results suggest that preanalytical and postanalytical error, which are not usually detectable by common quality control strategies, are not major sources of laboratory error. Further work is needed to reduce the unacceptably high rate of analytical errors.
实验室误差的分析前、分析中和分析后发生率尚未得到广泛研究。我们评估了连续提交至临床化学实验室用于测定血浆肌酐浓度的438份样本的实验室误差的分析前、分析中和分析后组成部分。我们进行红细胞抗原测定以确定患者-样本的一致性，对肌酐进行重复双份分析以检测分析误差，并追踪患者标本从实验室接收至实验室结果录入患者信息系统记录的过程。我们发现总误差率为9.36%。将总误差率细分为分析前、分析中和分析后组成部分，其误差率分别为0.00%、8.90%和0.46%。这些结果表明，通常无法通过常规质量控制策略检测到的分析前和分析后误差并非实验室误差的主要来源。需要进一步开展工作以降低高得令人无法接受的分析误差率。
