Home Medicine ‘Penelope test’: a practical instrument for checking appropriateness of laboratory tests
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‘Penelope test’: a practical instrument for checking appropriateness of laboratory tests

  • Simone Caruso , Dominika Szoke EMAIL logo and Mauro Panteghini
Published/Copyright: July 4, 2022
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 60 Issue 9

Abstract

In medical laboratories, the appropriateness challenge directly revolves around the laboratory test and its proper selection, data analysis, and result reporting. However, laboratories have also a role in the appropriate management of those phases of total testing process (TTP) that traditionally are not under their direct control. So that, the laboratory obligation to act along the entire TTP is now widely accepted in order to achieve better care management. Because of the large number of variables involved in the overall TTP structure, it is difficult to monitor appropriateness in real time. However, it is possible to retrospectively reconstruct the body of the clinical process involved in the management of a specific laboratory test to track key passages that may be defective or incomplete in terms of appropriateness. Here we proposed an appropriateness check-list scheme along the TTP chain to be potentially applied to any laboratory test. This scheme consists of a series of questions that healthcare professionals should answer to achieve laboratory test appropriateness. In the system, even a single lacking answer may compromise the integrity of all appropriateness evaluation process as the inability to answer may involve a significant deviation from the optimal trajectory, which compromise the test appropriateness and the quality of subsequent steps. Using two examples of the check-list application, we showed that the proposed instrument may offer an objective help to avoid inappropriate use of laboratory tests in an integrated way involving both laboratory professionals and user clinicians.

Keywords: appropriateness of laboratory tests; check-list; total testing process
Corresponding author: Dominika Szoke, UOC Patologia Clinica, Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Via GB Grassi 74, Milan, Italy, Phone: +39 02 6363 5295, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2022-04-15
Accepted: 2022-06-22
Published Online: 2022-07-04
Published in Print: 2022-08-26

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2022-0368
Keywords for this article
appropriateness of laboratory tests; check-list; total testing process

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Clinical Chemistry and Laboratory Medicine: enjoying the present and assessing the future
  4. Rethinking internal quality control: the time is now
  5. Review
  6. Multi-omics analysis from archival neonatal dried blood spots: limitations and opportunities
  7. Opinion Papers
  8. ‘Penelope test’: a practical instrument for checking appropriateness of laboratory tests
  9. Interference by macroprolactin in assays for prolactin: will the In Vitro Diagnostics Regulation lead to a solution at last?
  10. EFLM Paper
  11. Efficiency, efficacy and subjective user satisfaction of alternative laboratory report formats. An investigation on behalf of the Working Group for Postanalytical Phase (WG-POST), of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)
  12. General Clinical Chemistry and Laboratory Medicine
  13. Cross-reactivity in assays for prolactin and optimum screening policy for macroprolactinaemia
  14. Repository of intra- and inter-run variations of quantitative autoantibody assays: a European multicenter study
  15. Stability of direct renin concentration and plasma renin activity in EDTA whole blood and plasma at ambient and refrigerated temperatures from 0 to 72 hours
  16. Comparison of four different immunoassays and a rapid isotope-dilution liquid chromatography-tandem mass spectrometry assay for serum folate
  17. Analytical quality specifications in semen analysis according to the state of the current methodologies
  18. Reference Values and Biological Variations
  19. Short-term biological variation study of plasma hemophilia and thrombophilia parameters in a population of apparently healthy Caucasian adults
  20. First morning voided urinary gonadotropins in children: verification of method performance and establishment of reference intervals
  21. Derivation of sex and age-specific reference intervals for clinical chemistry analytes in healthy Ghanaian adults
  22. Cancer Diagnostics
  23. Serum free light chain analysis: persisting limitations with new kids on the block
  24. Cardiovascular Diseases
  25. Age partitioned and continuous upper reference limits for Ortho VITROS High Sensitivity Troponin I in a healthy paediatric cohort
  26. The predictive value of hemoglobin to creatinine ratio for contrast-induced nephropathy in percutaneous coronary interventions
  27. Infectious Diseases
  28. Health technology assessment to employ COVID-19 serological tests as companion diagnostics in the vaccination campaign against SARS-CoV-2
  29. Evaluation of a laboratory-based high-throughput SARS-CoV-2 antigen assay
  30. Presepsin levels in neonatal cord blood are not influenced by maternal SARS-CoV-2 infection
  31. Letters to the Editors
  32. How to evaluate fixed clinical QC limits vs. risk-based SQC strategies
  33. Reply to Westgard et al.: ‘Keep your eyes wide … as the present now will later be past’*
  34. Platelet phagocytosis by monocytes
  35. Early detection of Candida parapsilosis in peripheral blood as a result of a peripheral blood smear performed after cytographic changes on the Beckman Coulter UniCel DxH 800 hematology
  36. Pseudo-erythroblastosis on Sysmex XN hematology analyzers: a clue to Candida sepsis. Case report and literature review
  37. Covert poisoning with difenacoum: diagnosis and follow-up difficulties
  38. Comparison of Sebia Capillarys 3-OCTA with the Tosoh Bioscience HLC®-723G8 method for A1C testing with focus on analytical interferences and variant detection
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