[Quantitative evaluation of reproducibility of clinical laboratory data day by day].
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Biomedical subjects
Publications and source records attributed to I S Balakhovskiĭ.
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The potentialities of photometry in the ultraviolet, visible, and infrared spectra are compared. Errors associated with neglect of the Booger-Lambert-Ber law, nonmonochromic light, inconstant length of optic route, and non-optimal choice of optic density range are analyzed.
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Models of analytical series simulating good results and series with systematic errors were created on the basis of data bank of results of clinical biochemical analyses by computer simulation method. The quality of analyses was evaluated using chi 2 test. This parameter reacts to slight systematic errors and depends little on changes in the examined patient population; on the other hand, its sensitivity is the higher the longer is the analytical series. Statistical method for quality control by the chi 2 test is highly sensitive, absolutely objective, and requires no extra expenses for control studies.
The possibility of using chi 2 statistical test for quality control of laboratory studies was evaluated in a practical laboratory. In the overwhelming majority of cases the chi 2 test of analytical series, estimated from previous results or total sum of results of a month, indicates with certainty that this series is a random sampling. This unambiguously indicates analytical reliability of the results. Division of patients into inpatients and outpatients did not improve this parameter. The results were regularly much better for some analytical methods in comparison with other methods, which indicates their higher reliability.
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The creation of a noninvasive (without blood collection) method for measuring blood glucose concentrations, convenient for patients, is practically important, because the treatment of diabetics requires constant many-year monitoring of the alimentary component of glycemia. Use of IR spectra is impeded by the interference of strong bands of water absorption, whose concentration in the tissues is almost 1000 times higher than that of glucose. We investigated the effects of glucose, albumen, and blood serum on the structure of water absorption bands in the 1400-1600, 960, 1153, and 2000-2400 nm bands. The method of differentiated spectra was used. Glucose cleaved the negative aqueous band on the differential spectrum with 1410 and 1455 nm peaks and a positive 1590 nm peak with the isobestic point at 1540 nm. Albumen and serum proteins caused similar, although somewhat different effects, not preventing the use of the above wavelengths for the creation of a noninvasive device, because the concentrations of proteins and electrolytes are not changed after food intake if the homeostasis is intact.
Traditionally, the term "precision" denotes the quality of work, uniting the correctness and reproducibility of results. However, it can have another sense: the minimal difference between the specimens, detectable by this or that device or method. In order to rule out misunderstanding, we propose to use the term "measuring precision", if the term is used in its second meaning. It is easy to assess the measuring precision by statistical processing of large scope of data: if the histogram shows waves which disappear after the histogram step is increased, this means that the device and method used in this study permit biochemical analysis only at measuring precision corresponding to the histogram step at which the waves disappear. A table of measuring precision values is offered for 19 methods realized using the Labsystems FP-900 device (Finland) In many cases it is obviously low.
Computer programs for medical diagnostic laboratories which help save time needed for making files and improve their quality are to be differentiated from application programs for specific analyses. Any laboratory program consists of a nucleus and periphery. The nucleus includes the modules (which can be presented as individual files) carrying out the operations obligatory for any laboratory, such as registration of patients, making working lists, validation of results, making reports for clients and progress reports, archives, and quality systems. Modules ensuring the function of the program, namely, introduction of the names and parameters of methods, names of clients, staff personal, etc., are also referred to the nucleus. The periphery of a program consists of utilities or modules for certain analyzers, for data transfer to clients or to the central computer, and for sophisticated methods of data processing. A program meeting the medical requirements is to make use of only accredited methods of logical data processing, ensure the confidentiality and reliability of information, and keep records about the operations (who and when performed an operation and what operation was performed).
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