Assessment of critical values policies in Italian institutions: comparison with the US situation
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Elisa Piva
Abstract
Background: Critical value reporting is considered an essential tool to ensure the quality of medical laboratory services. Important issues include defining cut-off values, assessing responsibility for communication and adopting information technology solutions to improve notification. Here, we report the state of critical value reporting in a large cohort of Italian laboratories and comparison with Q-Probes surveys from the College of American Pathologists as representatives of the US situation.
Methods: To compare critical value policies and procedures, formulation of critical values list with critical values limits and monitoring tools, a web-based questionnaire was formulated for 389 institutions participating in the External Quality Assessment Schemes of Veneto Region, in Italy.
Results: A total of 90 clinical laboratories submitted data. Accredited laboratories represented 82.2% of participants, but written procedures for reporting were indicated by 70.5% of participants. Relevant differences between US and Italian policies have been observed, particularly regarding who provides the notification and on the formulation of the cut-off threshold for critical values.
Conclusions: Accreditation according to international standards can decrease differences regarding the management of critical values across laboratories of different countries. However, the issues concerning critical limits should be debated and a consensus critical values list should be considered. Automated systems could offer improvements regarding some issues, such as who makes the notification, reducing the time spent in notification of critical values. Surveys for comparing and improving existing policies regarding critical values should be promoted at an international level.
Clin Chem Lab Med 2010;48:461–8.
©2010 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Editorials
- Molecular biology and genetics in clinical chemistry and laboratory medicine
- Improving the post-analytical phase
- Reviews
- State of the art in therapeutic drug monitoring
- Decision criteria for rational selection of homogeneous genotyping platforms for pharmacogenomics testing in clinical diagnostics
- Reference Values and Biological Variations
- Assessment of critical values policies in Italian institutions: comparison with the US situation
- Genetics and Molecular Diagnostics
- Performance evaluation of the Abbott RealTime HCV Genotype II for hepatitis C virus genotyping
- Genotyping mitochondrial DNA single nucleotide polymorphisms by PCR ligase detection reactions
- FOXL2 mutations in Taiwanese patients with blepharophimosis, ptosis, epicanthus inversus syndrome
- Low expression of human β-defensin 1 in duodenum of celiac patients is partially restored by a gluten-free diet
- General Clinical Chemistry and Laboratory Medicine
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- Procalcitonin measurement in routine emergency medicine practice: comparison between two immunoassays
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- Simultaneous determination of serum tryptophan metabolites in patients with systemic lupus erythematosus by high performance liquid chromatography with fluorescence detection
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- Correlation between glucose and bupivacaine levels in cerebrospinal fluid after spinal anesthesia: glycorrhachia as predictor for duration of sensory block
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- Cardiovascular Diseases
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- Association of matrix metalloproteinase 9 genotypes and cardiovascular disease risk factors with serum matrix metalloproteinase 9 concentrations in Taiwanese individuals
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- Association of hyperhomocysteinemia with left ventricular dilatation and mass in human heart
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- High specificity but low sensitivity of the cartilage oligomeric matrix protein (COMP) test in rheumatoid arthritis and osteoarthritis
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