Autovalidation rates in an outpatient coagulation laboratory

Froom, Paul; Saffuri-Elias, Enas; Barak, Mira

doi:10.1111/ijlh.12386

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Once the algorithm is technically set up, decision upon whether all tests or specific test panels will be subject to AV should be made. The results of the survey showed that AV is most commonly applied to routine biochemistry tests, haematology and coagulation tests, and similar results are reported in literature (2,(14)(15)(16)(17). Some studies reported the use of AV for special biochemistry tests, i.e.…”

Section: Discussionsupporting

confidence: 73%

General position of Croatian medical biochemistry laboratories on autovalidation

Rimac

Jokić²,

Podolar³

et al. 2020

Biochem. med. (Online)

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Introduction: Autovalidation (AV) is an algorithm based on predefined rules designed, among others, to automate and standardize the postanalytical phase of laboratory work. The aim of this study was to examine the overall opinion of Croatian medical biochemistry laboratories regarding various aspects of AV. Material and methods: This retrospective study is an analysis of the responses of a survey about AV comprised of 18 questions, as part of Module 10 (“Postanalytical phase of laboratory testing”) of national External Quality Assessment program, administered by the Croatian Centre for Quality Assessment in Laboratory Medicine. Results were reported as percentages of total number of participants in survey or as proportions of observed data if the overall number of data was <100. Results: 121 laboratories responded to the survey, of which 76% do not use AV, while 11% of laboratories use AV in routine laboratory work. 16/29 laboratories implemented semi-automated AV for general biochemistry (7/29), haematology (5/29), and coagulation (4/29) tests. Analytical measurement ranges, critical values, flags from analysers, interference indices and delta check were the most commonly used rules in the algorithm. 12/29 laboratories performed validation of AV with less than 500 samples (8/29). 7/13 laboratories report the percentage of AV being 20-50%, while 10/13 answered that introduction of AV significantly reduced turnaround time (TAT) (for 20 - 25%), especially for biochemistry tests. Conclusions: Despite of its numerous benefits (i.e. shorter TAT, less manual validation, standardization of the postanalytical phase), only a small number of Croatian laboratories use AV.

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Section: Discussionsupporting

confidence: 73%

General position of Croatian medical biochemistry laboratories on autovalidation

Rimac

Jokić²,

Podolar³

et al. 2020

Biochem. med. (Online)

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“…Most of the published literature to date is limited to autoverification rules written in the hematology analyzer and the LIS. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 Reported autoverification rates for CBC results have ranged from 63% when rules were built in the analyzer 10 to 81% when written in LIS. 12 Similarly in coagulation, reported autoverification rates have ranged from 65% to 82%.…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 10 High rates of LIS-based autoverification were achieved in an outpatient hematology/coagulation laboratory; however, outpatient samples may be less complex to result than predominantly inpatient population. 6 , 7 We were able to find 1 report of a hematology laboratory that built autoverification rules in middleware and these authors used similar instrumentation and middleware as our laboratory. 13 They achieved an autoverification rate of 93.5% for CBC and 89.9% for individual CBC components, which was similar to our results of 97.2% for all CBCD and 88.3% for WBC differentials.…”

Section: Discussionmentioning

confidence: 99%

Customized middleware experience in a tertiary care hospital hematology laboratory

Roland

Yakimec

Markin

et al. 2022

Journal of Pathology Informatics

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“…The AV system in this study was designed according to three different decision limits that have been recommended in the literature ( 6 , 13 , 20 ). The AV passing rate was found between 77% and 85% based on the algorithms we developed.…”

Section: Discussionmentioning

confidence: 99%

“…A higher percentage of test results (83%) was autoverified based on the reference range ± TEa criterion. Previous studies have shown that by using the reference range ± TEa criterion, the AV passing rate varies between 73% and 85% ( 8 , 20 ). A study conducted by Shih et al concluded that the rate of AV was 92% for 25,526 patient reports and 42 biochemical tests using the 2nd and 98th percentiles of cumulative patient data ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Designing and validating an autoverification system of biochemical test results in Hatay Mustafa Kemal University, clinical laboratory

Gül

Özcan

Doğan

et al. 2022

Biochem. med. (Online)

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Introduction Autoverification (AV) is a postanalytical tool that uses algorithms to validate test results according to specified criteria. The Clinical and Laboratory Standard Institute (CLSI) document for AV of clinical laboratory test result (AUTO-10A) includes recommendations for laboratories needing guidance on implementation of AV algorithms. The aim was to design and validate the AV algorithm for biochemical tests. Materials and methods Criteria were defined according to AUTO-10A. Three different approaches for algorithm were used as result limit checks, which are reference range, reference range ± total allowable error, and 2nd and 98th percentile values. To validate the algorithm, 720 cases in middleware were tested. For actual cases, 3,188,095 results and 194,520 reports in laboratory information system (LIS) were evaluated using the AV system. Cohen’s kappa (κ) was calculated to determine the degree of agreement between seven independent reviewers and the AV system. Results The AV passing rate was found between 77% and 85%. The highest rates of AV were in alanine transaminase (ALT), direct bilirubin (DBIL), and magnesium (Mg), which all had AV rates exceeding 85%. The most common reason for non-validated results was the result limit check (41%). A total of 328 reports evaluated by reviewers were compared to AV system. The statistical analysis resulted in a κ value between 0.39 and 0.63 (P < 0.001) and an agreement rate between 79% and 88%. Conclusions Our improved model can help laboratories design, build, and validate AV systems and be used as starting point for different test groups.

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Autovalidation rates in an outpatient coagulation laboratory

Abstract: We conclude that an integrated system can result in a high autovalidation rate in a high-volume outpatient coagulation laboratory.

Cited by 7 publications

References 10 publications

General position of Croatian medical biochemistry laboratories on autovalidation

General position of Croatian medical biochemistry laboratories on autovalidation

Customized middleware experience in a tertiary care hospital hematology laboratory

Designing and validating an autoverification system of biochemical test results in Hatay Mustafa Kemal University, clinical laboratory

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