Quality Assessment of Interpretative Commenting in Clinical Chemistry

Lim, Ee Mun; Sikaris, Ken; Gill, Janice; Calleja, John; Hickman, Peter E.; Beilby, John; Vasikaran, Samuel

doi:10.1373/clinchem.2003.024877

Cited by 54 publications

(33 citation statements)

References 11 publications

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“…It is alarming that although in the present study laboratory professionals responsible for coagulation were asked to interpret the mixing studies, only staff at 49% of the laboratories in which mixing studies were implemented could adequately discriminate between inhibitory and non-inhibitory forms of uAPTT in all three scenarios. These results are similar to those of the postanalytical Quality Assurance Program in Australia, wherein participants were asked to add interpretative comments to a set of non-esoteric laboratory test results, and in which ≥ 50% of the interpretations were inappropriate and/or misleading [25].…”

Section: Interpretations Of Uaptt In Mixing Study Scenariossupporting

confidence: 59%

“…It is generally advisable that only professionals with clear expertise in the particular laboratory field should be charged with interpreting laboratory results [25,26]. It is alarming that although in the present study laboratory professionals responsible for coagulation were asked to interpret the mixing studies, only staff at 49% of the laboratories in which mixing studies were implemented could adequately discriminate between inhibitory and non-inhibitory forms of uAPTT in all three scenarios.…”

Section: Interpretations Of Uaptt In Mixing Study Scenariosmentioning

confidence: 76%

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An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation

Ajzner

Rogić

Meijer³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: An unexpectedly detected prolonged activated partial thromboplastin time (APTT) can be a harmless laboratory finding, but can also reflect a thrombotic tendency or a bleeding disorder. The assistance of laboratory professionals in the interpretation of an unexpectedly detected prolonged APTT (uAPTT) is often required. The way in which uAPTTs are evaluated in laboratories was assessed in this international study with the aim of determining whether laboratory professionals are able to fulfill this need. Methods: Postanalytical practices after uAPTT were investigated and the mixing study methodology (if used) was studied by circulating a case report with a questionnaire to staff in the invited laboratories. In addition, the interpretations of those staff regarding the presence or absence

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Section: Interpretations Of Uaptt In Mixing Study Scenariossupporting

confidence: 59%

Section: Interpretations Of Uaptt In Mixing Study Scenariosmentioning

confidence: 76%

An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation

Ajzner

Rogić

Meijer³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…This is not surprising given that doctors at graduation often lack adequate training in test ordering and result interpretation (4). However, inappropriate commenting by inadequately trained laboratory personnel can be dangerous (5,6). Training in pathology consultation has to be undertaken in a formal manner for this activity to be performed effectively (7).…”

Section: Introductionmentioning

confidence: 99%

“…Training in pathology consultation has to be undertaken in a formal manner for this activity to be performed effectively (7). There is now some acceptance in the clinical chemistry profession for the need and ability to assess the quality of interpretative services offered by the clinical chemistry laboratory (6,8,9). We describe a study of interpretative commenting ability among laboratory personnel in the Asia-Pacific region and Africa.…”

Section: Introductionmentioning

confidence: 99%

Quality of interpretative commenting on common clinical chemistry results in the Asia-Pacific region and Africa

Vasikaran¹,

Lai²,

Sethi

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Interpretative commenting is an important activity of the clinical diagnostic laboratory. We describe a study of interpretative commenting abilities among senior laboratory professionals in the Asia-Pacific region and Africa. Methods: Five sets of laboratory results reflecting common and important problems encountered in clinical chemistry were distributed at 4-weekly intervals to 31 registered participants from countries in the Asia-Pacific region and Africa. Participants were asked to attach an interpretative comment to the results assuming that the requesting doctor had asked for an interpretation of the result. Results: Twelve pathologists and 19 scientists from seven countries registered to participate and the overall reply rate was ;50% for the five cases. The quality of the comments returned by participants was diverse and some reflected incorrect or misleading interpretation and advice. Conclusions: While interpretative commenting is an important laboratory activity, the results of this study suggest that there is room for improvement in the quality of interpretative comments offered by senior laboratory professionals, even for commonly reported results relating to most prevalent and important public health conditions. Interpretative commenting should be formally taught during training of patho-

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“…There is some evidence that they lead to improved outcomes compared to reports without comments [13]. The quality of interpretive commenting in clinical chemistry has been assessed by proficiency testing schemes and has found that unacceptable interpretation can be made [14][15][16][17] and lead to the conclusion that formal training of pathologists and clinical scientists should be provided [18][19][20], concentrating on how to comment as much as what to comment [21,22].…”

Section: The Post-analytical Phasementioning

confidence: 99%

Performance criteria of the post-analytical phase

Sikaris¹

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Quality in healthcare is ideally at an optimal benchmark, but must be at least above the minimal standards for care. While laboratory quality is ideally judged in clinical terms, laboratory medicine has also used biological variations and state-of-the-art criteria when, as is often the case, clinical outcome studies or clinical consensus are not available. The post-analytical phase involves taking quality technical results and providing the means for clinical interpretation in the report. Reference intervals are commonly used as a basis for data interpretation; however, laboratories vary in the reference intervals they use, even when analysis is similar. Reference intervals may have greater clinical value if they are both optimised to account for physiological individuality, as well as if they are harmonised through professional consensus. Clinical decision limits are generally superior to reference intervals as a basis for interpretation because they address the specific clinical concern in any patient. As well as providing quality data and interpretation, the knowledge of laboratory experts can be used to provide targeted procedural knowledge in a patient report. Most profoundly critically abnormal results should to be acted upon to minimise the risk of mortality. The three steps in quality report interpretation, (i) describing the abnormal data, (ii) interpreting the clinical information within that data and (iii) providing knowledge for clinical follow-up, highlight that the quality of all laboratory testing is reflected in its impact on clinical management and improving patient outcomes.

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Quality Assessment of Interpretative Commenting in Clinical Chemistry

Cited by 54 publications

References 11 publications

An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation

An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation

Quality of interpretative commenting on common clinical chemistry results in the Asia-Pacific region and Africa

Performance criteria of the post-analytical phase

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