PubMed · 8906070
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G Miller. 1996. How useful are reference materials?. https://pubmed.ncbi.nlm.nih.gov/8906070/
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Information theoretical concepts can be used as most valuable tools for evaluating clinical chemical tests. They offer several advantages over the conventional test evaluation by Bayesian concepts. Although long known, information theory has failed to gain widespread acceptance among clinical chemists, probably due to the rather laborious computation of the necessary quantities. To resolve this technical problem, this paper demonstrates how commonly available computer spreadsheet programs can assist in the computation of information theoretical quantities such as the diverse entropies and the information content. Two spreadsheet versions are presented: firstly, a working sheet is developed for information theoretical evaluation of a two-by-two contingency table corresponding to a dichotomous diagnostic problem (e.g., diseased versus non-diseased) and a dichotomous diagnostic test outcome (e.g., normal versus abnormal), and secondly, a working sheet is shown for a more general situation with up to ten diagnostic alternatives and up to ten possible test outcomes. Typical examples for application of these tools are demonstrated.
We studied laboratory internal quality control (QC) processes using the College of American Pathologists Q-Probes program. Over 500 institutions participated, providing practices based on approximately 710,000 cholesterol, 880,000 calcium, 400,000 digoxin, and 1,180,000 hemoglobin QC results. The costs of QC included participant median control samples rates comprising 9.1, 9.4, 37.0, and 6.8% for the four analytes respectively, repeat patient test rates of 0.36% for hemoglobin to 0.65% for digoxin, and median delays in reporting results when QC exceptions occurred of 15.8 min for calcium to 24.7 min for hemoglobin. Quality control practices were complex and highly variable among participants and frequently differed from internal laboratory protocols and from long-established quality guidelines. We conclude that QC is costly, and laboratorians frequently do not follow established QC practices, in part because they are complex. To improve compliance, we believe QC practices must be simplified.
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