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1.
IntroductionThe detection and prevention of errors in the postanalytical phase can be done through the harmonization and standardization of constituent parts of this phase of laboratory work. The aim was to investigate how well the ongoing management of the postanalytical phase corresponds to the document “Post-analytical laboratory work: national recommendations” in Croatian medical biochemistry laboratories (MBLs).Materials and methodsAll 195 MBLs participating in the national external quality assessment scheme, were invited to undertake a part in a survey. Through 23 questions the participants were asked about management of the reference intervals (RI), delta check, reflex/reflective testing, postanalytical quality indicators and other parts of the postanalytical phase recommended in the national recommendations. The results are presented in numbers and percentages.ResultsOut of 195 MBLs, 119 participated in the survey, giving a response rate of 61%. Not all of the respondents provided answers to all the questions. Delta check has not been used in 59% (70/118) of the laboratories. Only 22/113 (20%) laboratories use reflex and/or reflective testing. In 53% of the laboratories, critical results were reported within 30 minutes of the confirmation of the results. In 34% (40/118) of the laboratories, turnaround time and reporting of critical results are two most often monitored postanalytical quality indicators.ConclusionThe results showed the critical results reporting and monitoring of postanalytical quality indicators are in the line with the recommendations. However, the management of RI verification, the use of delta check and reflex/reflective testing still must be harmonized among Croatian MBLs.  相似文献   

2.
IntroductionEpithelial cells (ECs) are structures regularly observed during urine microscopy analysis. The correct identification of EC subtypes can be useful since renal tubular epithelial cells (RTECs) are clinically relevant. We investigate the urinary ECs report and the judgement of its clinical importance by Brazilian laboratories.Materials and methodsA survey with four questions was made available to participants of the Urinalysis External Quality Assessment Program (EQAP) from Controllab. Laboratories composed 3 groups: (1) differentiating ECs subtypes: “squamous”, “transitional” and “RTECs”; (2) differentiating ECs subtypes: “squamous” or “non-squamous” cells; (3) without ECs subtype identification. Participants did not necessarily answer to all questions and the answers were evaluated both within the same laboratory’s category and within different categories of laboratories.ResultsA total of 1336 (94%) laboratories answered the survey; Group 1, 119/140 (85%) reported that ECs differentiation is important to the physician and 62% want to be evaluated by EQAP, while in Group 3, 455/1110 (41%) reported it is useful to them, however only 25% want be evaluated by EQAP. Group 2 laboratories 37/51 (73%) reported that the information is important, but only 13/52 (25%) are interested in an EQAP with differentiation of the 3 ECs subtypes.ConclusionMost of the laboratories do not differentiate ECs in the three subtypes, despite the clinical importance of RTECs. Education of laboratory staff about the clinical significance of urinary particles should be considered a key priority.  相似文献   

3.
A system of differential equations A(d/dt) x = Bx+f, along with the initial condition x(0) = k, is considered where A and B are m x n matrices. Generalized inverses of the matrix A are used to derive algebraic conditions for the existence and uniqueness of a solution. An example is presented to illustrate application of the results to circuit theory.  相似文献   

4.
IntroductionThe COVID-19 pandemic has posed several challenges to clinical laboratories across the globe. Amidst the outbreak, errors occurring in the preanalytical phase of sample collection, transport and processing, can further lead to undesirable clinical consequences. Thus, this study was designed with the following objectives: (i) to determine and compare the blood specimen rejection rate of a clinical laboratory and (ii) to characterise and compare the types of preanalytical errors between the pre-pandemic and the pandemic phases.Materials and methodsThis retrospective study was carried out in a trauma-care hospital, presently converted to COVID-19 care centre. Data was collected from (i) pre-pandemic phase: 1st October 2019 to 23rd March 2020 and (ii) pandemic phase: 24th March to 31st October 2020. Blood specimen rejection rate was calculated as the proportion of blood collection tubes with preanalytical errors out of the total number received, expressed as percentage.ResultsTotal of 107,716 blood specimens were screened of which 43,396 (40.3%) were received during the pandemic. The blood specimen rejection rate during the pandemic was significantly higher than the pre-pandemic phase (3.0% versus 1.1%; P < 0.001). Clotted samples were the commonest source of preanalytical errors in both phases. There was a significant increase in the improperly labelled samples (P < 0.001) and samples with insufficient volume (P < 0.001), whereas, a significant decline in samples with inadequate sample-anticoagulant ratio and haemolysed samples (P < 0.001).ConclusionIn the ongoing pandemic, preanalytical errors and resultant blood specimen rejection rate in the clinical laboratory have significantly increased due to changed logistics. The study highlights the need for corrective steps at various levels to reduce preanalytical errors in order to optimise patient care and resource utilisation.  相似文献   

5.
BackgroundInfectious Pancreatic Necrosis Virus (IPNV) is the etiological agent of a highly contagious disease that affects salmonids. In Chile, the second worldwide salmon producer, IPNV causes great economic loss and is one of the most frequently detected pathogens. Due to its high level of persistence and the lack of information about the efficiency of its diagnostic techniques, the National Reference Laboratory (NRL) for IPNV in Chile performed the first inter-laboratory ring trial, to evaluate the sensitivity, specificity and repeatability of the qRT-PCR detection methods used in the country.ResultsResults showed 100% in sensitivity and specificity in most of the laboratories. Only three of the twelve participant laboratories presented problems in sensitivity and one in specificity. Problems in specificity (false positives) were most likely caused by cross contamination of the samples, while errors in sensitivity (false negatives) were due to detection problems of the least concentrated viral sample. Regarding repeatability, many of the laboratories presented great dispersion of the results (Ct values) for replicate samples over the three days of the trial. Moreover, large differences in the Ct values for each sample were detected among all the laboratories.ConclusionsOverall, the ring trial showed high values of sensitivity and specificity, with some problems of repeatability and inter-laboratory variability. This last issue needs to be addressed in order to allow harmonized diagnostic of IPNV within the country. We recommend the use of the NRL methods as validated and reliable qRT-PCR protocols for the detection of IPNV.  相似文献   

6.
IntroductionActivated partial thromboplastin time (aPTT) is determined and reported as clotting time in seconds aPTT(s), but it is presumed that reporting results as patient-to-normal clotting time ratio, aPTT(r), could minimize within-laboratory variability. The aim of study was to investigate differences in reporting aPTT results that can affect comparability of the results among Croatian laboratories and suggest further steps for its harmonization.Materials and methodsThe questionnaire on aPTT reporting practice was distributed to 83 laboratories through Survey Monkey application in March 2019 as the part of the first regular round of Croatian Centre for Quality Assessment in Laboratory Medicine proficiency testing.ResultsThe survey response rate was 0.49. Majority of laboratories report aPTT results as both, seconds and ratio. Participants reported use of 23 different aPTT(s) reference intervals along with 17 different combinations of reagent/coagulometer and 25 aPTT(s) denominators of different origin for aPTT(r) calculation. Despite the same aPTT(s) results, the use of different denominators caused a dispersion of aPTT(r) results that can lead to exceeding external quality assessment performance criteria of 7%, particularly when results were compared for the same reagent group only. By applying aPTT(s) reference interval mean as denominator for calculation of aPTT(r) reference interval better concordance to harmonized one was obtained (17 vs. 27; χ2 = 3.972; P = 0.046).ConclusionIn order to improve comparability of the results, laboratories are advised to use mean of aPTT(s) reference interval as denominator for aPTT(r) calculation. Type of coagulometer need to be considered when evaluating aPTT proficiency test results and its currently acceptable limit of performance evaluated accordingly.  相似文献   

7.

Using Layder's domain theory (1997) Layder, D. 1997. Modern social theory:Key debates and new directions, London: UCL Press.  [Google Scholar] as an analytical framework, this article shows how the information society can be measured through various levels of society. Layder's notions of psychobiography, situated activity, social setting, and contextual resources help identify cultural and social indicators for understanding changes in the information society. With the help of empirical indicators for each domain, this article uses the case of Estonia to show that there is often more to the information society than what is captured by traditional measures. This article calls for a context-sensitive approach, which takes into consideration social and cultural indicators. Measurements from all four domains are necessary for understanding the complexity of information-society-related issues.  相似文献   

8.

Introduction

To investigate the state of the art of intra-laboratory turnaround time (intra-TAT), provide suggestions and find out whether laboratories accredited by International Organization for Standardization (ISO) 15189 or College of American Pathologists (CAP) will show better performance on intra-TAT than non-accredited ones.

Materials and methods

479 Chinese clinical laboratories participating in the external quality assessment programs of chemistry, blood gas, and haematology tests organized by the National Centre for Clinical Laboratories in China were included in our study. General information and the median of intra-TAT of routine and stat tests in last one week were asked in the questionnaires.

Results

The response rate of clinical biochemistry, blood gas, and haematology testing were 36% (479 / 1307), 38% (228 / 598), and 36% (449 / 1250), respectively. More than 50% of laboratories indicated that they had set up intra-TAT median goals and almost 60% of laboratories declared they had monitored intra-TAT generally for every analyte they performed. Among all analytes we investigated, the intra-TAT of haematology analytes was shorter than biochemistry while the intra-TAT of blood gas analytes was the shortest. There were significant differences between median intra-TAT on different days of the week for routine tests. However, there were no significant differences in median intra-TAT reported by accredited laboratories and non-accredited laboratories.

Conclusions

Many laboratories in China are aware of intra-TAT control and are making effort to reach the target. There is still space for improvement. Accredited laboratories have better status on intra-TAT monitoring and target setting than the non-accredited, but there are no significant differences in median intra-TAT reported by them.Key words: quality indicators, quality control, clinical laboratory services  相似文献   

9.

Introduction:

Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear.

Materials and methods:

All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory’s parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO).

Results:

Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling.

Conclusions:

Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low.  相似文献   

10.
科技期刊注重科技伦理评估的做法及实例分析   总被引：1，自引：1，他引：0  
【目的】促进科技期刊的正确导向,提升科技期刊对科技伦理的重视程度,加强普通科技期刊进行科技伦理评估的力度。【方法】 阐述了科技期刊重视科技伦理评估的道德意义,提出了科技伦理评估的具体做法。【结果】 发现通过消除伪科技伦理谣言、关注国际科技伦理的热点、刊发前瞻性科技伦理专业论文、结合新闻热点约稿、解疑释惑等方法是科技期刊实现科技论文评估的具体途径。【结果】 科技期刊论文的科技伦理评估还在起步阶段,需要进一步完善伦理委员会的审查、监督体系,提高作者和编辑的科技伦理学意识等等。  相似文献   

11.
[目的]根据论文的特点,从信息质量理论中提炼出有助于提高编辑初审工作质量的有效方法。[方法]根据Strong D M等人提出的信息质量定义,演绎推理论文信息质量的定义;根据信息质量的PSP/IQ模型,结合论文的特点和初审实践,从中归纳概括论文信息质量的维度,从而形成编辑初审的"论文信息质量5维法"。[结果]提出了学术期刊论文信息质量的概念,并探究了它的5个维度,形成了相应的论文信息质量5维法作为编辑初审的一种新方法。[结论]论文信息质量5维法在事实上和理论上都为编辑初审工作提供了一种可资借鉴的新思路和新方法。  相似文献   

12.
IntroductionInterpretation of laboratory test results is a complex post-analytical activity that requires not only understanding of the clinical significance of laboratory results but also the analytical phase of laboratory work. The aims of this study were to determine: 1) the general opinion of Croatian medical biochemistry laboratories (MBLs) about the importance of interpretative comments on laboratory test reports, and 2) to find out whether harmonization of interpretative comments is needed.Materials and methodsThis retrospective study was designed as a survey by the Working Group for Post-analytics as part of national External Quality Assessment (EQA) program. All 195 MBLs participating in the national EQA scheme, were invited to participate in the survey. Results are reported as percentages of the total number of survey participants.ResultsOut of 195 MBLs, 162 participated in the survey (83%). Among them 59% MBLs implemented test result comments in routine according to national recommendations. The majority of laboratories (92%) state that interpretative comments added value to the laboratory reports, and a substantial part (72%) does not have feedback from physicians on their significance. Although physicians and patients ask for expert opinion, participants stated that the lack of interest of physicians (64%) as well as the inability to access patient’s medical record (62%) affects the quality of expert opinion.ConclusionAlthough most participants state that they use interpretative comments and provide expert opinions regarding test results, results of the present study indicate that harmonization for interpretative comments is needed.  相似文献   

13.

Introduction

Early identification and management of chronic kidney disease (CKD) is highly cost-effective and can reduce the risk of kidney failure progression and cardiovascular disease. In 2014, the Joint Croatian Working Group (JCWG) for laboratory diagnostic of CKD on the behalf of Croatian society of medical biochemistry and laboratory medicine (CSMBLM) and Croatian chamber of medical biochemists (CCMB) conducted a survey across Croatian medical-biochemistry laboratories to assess the current practice in this area of laboratory medicine. The aim of this study was to present the data collected through the survey and to give insight about laboratory diagnostics of chronic kidney disease in Croatia.

Materials and methods

An invitation to participate in the survey was sent to all Croatian medical-biochemistry laboratories (N = 196). The questionnaire was designed in a form of questions and statements, with possible multiple answers, comprising 24 questions.

Results

The response rate was 80/196 (40.8%). 39 answers were from primary medical-biochemistry laboratories. 31/78 (0.40) laboratories measure creatinine with non-standardized method (uncompensated Jaffe method). 58/78 (0.74) of laboratories that measure creatinine do not report eGFR values. Similar number of laboratories (58/80, 0.73) do not measure urine albumin or protein.

Conclusions

There is a large heterogeneity among Croatian laboratories regarding measuring methods, reporting units and reference intervals (cut-off values), both for creatinine and urine albumin or protein. The two key prerequisites for CKD screening, automatic reporting of eGFR and albuminuria or proteinuria assessment, are not implemented nationwide. There is a need for harmonization in laboratory diagnostics of CKD in Croatia.Key words: survey, chronic kidney disease, estimated glomerular filtration rate (eGFR), albuminuria, proteinuria, creatinine, harmonization  相似文献   

14.
BackgroundLytic bacteriophages are bacterial viruses that upon infection kill their host cells and therefore have re-emerged as biological control agents of bacterial pathogens, particularly in the field of food related infections. Here, we investigated the stability in different food matrices of five phage isolates capable of controlling the foodborne pathogen Salmonella enterica serovar Enteritidis (SE).ResultsWe found that two phages, originally isolated from food sources, were up to 5 logs more stable than three phages isolated from sewage, in ten food matrices (fresh and processed) at both 4°C and 18°C.ConclusionLytic phages isolated from contaminated food sources seem to be a better choice when structuring phage cocktails to be used in the control of SE in food management protocols.  相似文献   

15.
我国SCI收录期刊主要文献计量学指标国际对比   总被引：1，自引：1，他引：0  
【目的】了解我国SCI收录期刊的主要文献计量学指标整体水平在国际上排名,为正确认识我国SCI收录期刊的情况提供一定参考。【方法】 把我国(不含台湾省SCI收录期刊)与G7国家(美国、英国、法国、德国、意大利、加拿大、日本)和新兴国家(韩国、印度和俄罗斯)2013年SCI收录期刊主要文献计量学指标进行对比。【结果】 2013年我国SCI收录期刊数(162种)位居11个国家中第6位,刊均被引频次位居第8位;我国SCI收录期刊刊均论文数相对较多、自引率相对较高、特征因子和论文影响分值较低;论著篇均引文数位居第7位,而综述篇均引文数位居第4位。【结论】我国SCI收录期刊为进一步提高国际影响力和希望加入SCI期刊可从以下方面努力:期刊出版语言改为英语、减少期刊年均论文数、稿源丰富期刊可缩短出版周期或提高论文录用标准、严格控制期刊自引数量等。  相似文献   

16.
科技期刊论文低被引情况与探讨   总被引：1，自引：1，他引：0  
【目的】从低被引论文所占比例及分布情况出发考察期刊学术质量,呼吁编辑同行做引文分析时可适当关注低被引论文情况,以期全方位认识刊物存在的问题。【方法】 选取零被引率、一次被引率、一次被引率减零被引率、二次被引率减一次被引率4种指标,定量考察光电类期刊、电子通信类期刊、工程技术综合类高校学报的载文低被引情况,同时将其和主流正向指标进行比较,发现二者排名并非一致。【结果】 我国科技期刊普遍存在低被引论文所占比例高的现象,收稿范围越大类别的期刊问题越突出,且反向考察期刊论文低被引情况能对正向指标表征的期刊评价信息予以补充。【结论】科技期刊编辑可从低被引论文所占比例、指标历年变化趋势、被引次数分布等几方面对期刊现状予以关注。  相似文献   

17.
IntroductionThe aim of this study was to perform a comprehensive verification of a 6-part differential haematology analyser Siemens Advia 2120i (Erlangen, Germany), prior to its routine implementation.Materials and methodsOur verification protocol included: precision (within- and between-run), estimated bias (%) as measure of trueness, which was calculated from observed and manufacturers’ declared value, analytical measuring interval (AMI), carryover, confirmation of a limit of blank (LoB), determination of a limit of detection (LoD) and limit of quantitation (LoQ). The K2 ethylenediaminetetraacetic acid (EDTA) patients’ leftover samples were used for verification of analyser Advia 2021i. Acceptance criteria were based on manufacturer technical specifications (Siemens), 2016 state-of-the-art criteria (Vis and Huisman), and EFLM Biological Variation Database.ResultsThe within- and between-run precision were acceptable for all parameters and the lowest coefficients of variation were observed for mean corpuscular volume (MCV) (0.3% and 0.6%, respectively). Estimated bias was within the acceptance criteria for all parameters except for MCV (the estimated bias was 2.2% (acceptance criteria 2.0%). AMI was confirmed for all tested parameters (r > 0.99). The carryover estimates ranged from 0.1% for platelet count (Plt) to 0.6% for red blood cell count and were within the manufacturers’ specifications (≤ 1%). Manufacturers’ claims for LoB were confirmed for leukocytes, erythrocytes, haemoglobin, and platelets. The estimated LoD and LoQ were 0.05 x109/L and 0.1 x109/L for white blood cell count, while for Plt values were 2 x109/L and 3 x109/L, respectively.ConclusionsAnalytical performance of the Siemens Advia 2120i meets predefined quality goals and is suitable for routine use in a clinical laboratory.Key words: verification, haematology analyser, haematology, blood cell count  相似文献   

18.
This is the result of a Survey of diagnostics laboratories in the Asia Pacific (APAC) region with perspectives on India, investigating the three key aspects that are central to the success of a laboratory: quality, cost and speed. This Survey provides a comparison in selected performance indicators in a large number of diagnostic laboratories in a broad range of countries in the APAC region. The Survey provides data on some key performance characteristics such as quality improvement activities, staff productivity and Turnaround Time (TAT). This Survey also demonstrates in India the common issues facing all the laboratories surveyed but also common solutions using a Quality Systems approach which involves Accreditation, customer responsiveness, greater use of IT, automation and Lean principles. Indian laboratories reported less automation and fewer laboratories have Laboratory Information Systems. The productivity by various measures in Indian laboratories was less than in other APAC laboratories. TAT was more commonly monitored in the Indian specimens though there were fewer laboratories compared with the APAC specimens where there were separate TATs for Short Turnaround Time and Routine specimens.  相似文献   

19.
A class of matrices with 1, -1 and 0 entries, called the H-matrices, is introduced and properties of such matrices are investigated. It is shown that for an H-matrix K the matrix G = KDKT, where D is a diagonal matrix with nonnegative diagonal entries, has certain properties applicable to topological synthesis of networks. A technique for decomposing a particular symmetrical matrix G, called the Q-matrix, into KDKT, where K is an H-matrix and D is a diagonal matrix with positive diagonal entries, is also developed.  相似文献   

20.

Introduction

Poor harmonization of critical results management is present in various laboratories and countries, including Croatia. We aimed to investigate procedures used in critical results reporting in Croatian medical biochemistry laboratories (MBLs).

Materials and methods

An anonymous questionnaire, consisting of 24 questions/statements, related to critical results reporting procedures, was send to managers of MBLs in Croatia. Participants were asked to declare the frequency of performing procedures and degree of agreement with statements about critical values reporting using a Likert scale. Total score and mean scores for corresponding separate statements divided according to health care setting were calculated and compared.

Results

Responses from 111 Croatian laboratories (48%) were analyzed. General practice laboratories (GPLs) more often re-analyzed the sample before reporting the critical result in comparison with the hospital laboratories (HLs) (score: 4.86 (4.75-4.96) vs. 4.49 (4.25-4.72); P = 0.001) and more often reported the critical value exclusively to the responsible physician compared to HLs (4.46 (4.29-4.64) vs. 3.76 (3.48-4.03), P < 0.001). High total score (4.69 (4.56-4.82)) was observed for selection of the critical results list issued by the Croatian Chamber of Medical Biochemistry (CCMB) indicating a high harmonization level for this aspect of critical result management. Low total scores were observed for the statements regarding data recording and documentation of critical result notification.

Conclusions

Differences in practices about critical results reporting between HLs and GPLs were found. The homogeneity of least favorable responses detected for data recording and documentation of critical results notification reflects the lack of specific national recommendations.Key words: critical results, laboratory testing, quality indicators, survey, post-analytical phase  相似文献   

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