Improvement of the post-analytical phase by means of an algorithm based autoverification

N. S. Yılmaz, Bayram Şen, Burak Arslan, Tuba Saadet Deveci Bulut, B. Narlı, N. Afandiyeva, Gülce Koca, Canan Yılmaz, Ozlem Gulbahar
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Abstract

Abstract Objectives Autoverification (AV) is releasing laboratory results using predefined rules. AV standardizes the verification of laboratory results, improves turnaround time (TAT), detects errors in the total test process, and enables effective use of laboratory staff. In this study, we aimed to evaluate the outcomes of implementing the AV in a tertiary hospital. Methods The study was performed in Gazi University Health Research and Application Hospital, Core Biochemistry Laboratory, between August 2017 and October 2019. Step by step, AV algorithms were designed and implemented via middleware for 29 clinical biochemistry tests. A comprehensive validation was performed before the AV system was run. Initially, AV system was tested with datasets and simulated patients (dry testing). Next, samples that may violate AV rules were tested anonymously with no-named trial barcodes (wet testing). Finally, validation of the system was performed with real patients, while the AV was running in the background but not active (i.e., while the manual verification was still going on). After all these steps were successful, the system was started. Results In the daytime, AV rates were ≥75 % for 23 of 29 tests. In night-shift, AV rates were ≥70 % for 16 of 25 tests. Report-based performance was found 26 % for daytime. TAT in the daytime decreased after AV implementation. Conclusions Although this is the first time we have implemented the AV, a significant percentage of the tests have been verified. However, approaches that will increase the percentage of report-based verification will enhance the efficiency of autoverification.
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通过基于算法的自动核查改进后分析阶段
摘要 目的 自动核查(AV)是使用预定义的规则发布实验室结果。自动核查使化验结果的验证标准化,缩短了周转时间(TAT),发现了整个化验过程中的错误,并能有效地使用化验室工作人员。在本研究中,我们旨在评估一家三级医院实施 AV 的结果。方法 研究于 2017 年 8 月至 2019 年 10 月期间在加齐大学健康研究与应用医院核心生化实验室进行。通过中间件逐步设计并实施了 29 种临床生化检验的 AV 算法。在 AV 系统运行之前,进行了全面的验证。首先,使用数据集和模拟患者(干测试)对视听系统进行测试。接着,使用无名试验条形码对可能违反反病毒规则的样本进行匿名测试(湿测试)。最后,在反病毒系统后台运行但未激活(即人工验证仍在进行)的情况下,使用真实患者对系统进行验证。所有这些步骤完成后,系统启动。结果 在日班,29 次测试中有 23 次的 AV 率≥75%。在夜班,25 次测试中有 16 次的 AV 率≥70%。日班时,基于报告的绩效为 26%。实施 AV 后,白天的 TAT 有所下降。结论 虽然这是我们第一次实施 AV,但相当大比例的测试都得到了验证。不过,提高基于报告的验证比例的方法将提高自动验证的效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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