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Title: Ο εντοπισμός των μη αναλυτικών σφαλμάτων στο εργαστήριο κλινικής χημείας
Μέθοδοι εντοπισµού µη αναλυτικών σφαλµάτων στο εργαστήριο κλινικής χηµείας
Authors: Καρκαλούσος, Πέτρος
Item type: Journal article
Keywords: Στατιστικός έλεγχος ποιότητας;Μη αναλυτικά σφάλµατα;∆ιαφορές ∆έλτα;Χάσµα Ανιόντων;Κρίσιµες Τιµές;Statistical quality control;No-analytical mistakes;Delta Checks;Anion Gap;Critical Values
Subjects: Medicine
Issue Date: 6-May-2015
Date of availability: 6-May-2015
Language: Greek
Citation: Καρκαλούσος, Π. (2004) Μέθοδοι εντοπισµού µη αναλυτικών σφαλµάτων στο εργαστήριο κλινικής χηµείας. "Εφαρμοσμένη Κλινική Μικροβιολογία και Εργαστηριακή Διαγνωστική", 9 (3), σ. 118-131. Διαθέσιμο στο: [Έγινε Πρόσβαση].
Journal: Εφαρμοσμένη Κλινική Μικροβιολογία και Εργαστηριακή Διαγνωστική
Type of Journal: With a review process (peer review)
Table of contents: Gross errors are serious laboratory mistakes which are usually due to human factors or to hardware damages. They are a large group of errors and they happened usually before or after the analytical determination. Its detection is sometimes too easy (breakdown of analyzer) but other times too difficult (secretarial mistakes, sampling mix-up). Gross errors change the patients’ results and cause a very serious medical mistake. Their large proportion (almost the 90% of the total laboratory mistakes) force the laboratory scientists to put into practice statistical methods for their quick detection. The most important of these methods are Delta Checks. These are the differences between the most recent results and the former results of the same patient. These differences are compared to specific reference values. The estimation of these reference values can be based on the biological variation of each analyte or on statistical analysis of numerous values. The best statistical method is the measuring of the 5th and 95th percentile. Accepted Delta Checks are considered the values between 5th and 95th percentile. Delta Checks lower than 5th percentile or larger than 95th percentile are considered as “outliers” and the analyzer’s user must find the reason which causes it. The reason may be a gross mistake or a dramatically change of the patient’s health. In any case the laboratory personnel must find which of these two happened before the patient takes his results. Other methods that can be used in parallel with Delta Checks are Anion Gap and Critical Limits. Anion Gap is usually estimated by the equation [Na+]– ([HCO3-] + [Cl-]) and it is used only on analyzers which determinate all the anions. Anion Gap values larger than 24 mmol/lt or lower than 2 mmol/lt are considered as “outliers”. Critical Values are the analyte’s concentrations which are extremely dangerous for the patient’s life. It is also possible critical values to be due to a gross error. For the reasons described, these determinations must be repeated and the history file of the patient must be checked.
Access scheme: Publicly accessible
License: Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ηνωμένες Πολιτείες
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