Evidence-based approach for the generation of a multivariate logistic regression model that predicts instrument failure.

Stephan L Cleveland, Carol A Carman, Niti Vyas, Jose H Salazar, Juan U Rojo
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Abstract

Objective: Identification of instrument failure (IF) represents a point to improve the quality of services provided by medical laboratories. Here, a logistic regression model was created to define the relationship between instrument downtime and laboratory quality management systems.

Methods: Interval-level quality control (QC) and categorical quality assurance data from 3 identical chemistry analyzers was utilized to generate a logistic regression model able to predict IF. A case-control approach and the forward stepwise likelihood-ratio method was used to develop the logistic regression model. The model was tested using a case-control dataset and again using the complete sample.

Results: A total of 650 downtime events were identified. A total of 22,880 QC data points, 187 calibrations, 24 proficiency testing events, and 107 maintenance records were analyzed. The regression model was able to correctly predict 59.2% of no instrument downtime events and 69.2% of instrument downtime events using the case-control data. Using the entire data set, the sensitivity of the model was 69.2% and the specificity was 58.2%.

Conclusion: A logistic regression model can predict instrument downtime nearly 70% of the time. This study acts as a proof of concept using a limited data set collected by the chemistry laboratory.

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基于证据的方法,生成可预测仪器故障的多元逻辑回归模型。
目的:仪器故障(IF)的识别是提高医学实验室服务质量的关键。在此,我们建立了一个逻辑回归模型,以确定仪器故障时间与实验室质量管理系统之间的关系:方法:利用来自 3 台相同化学分析仪的区间质量控制(QC)和分类质量保证数据,建立了一个能够预测 IF 的逻辑回归模型。在建立逻辑回归模型时,采用了病例对照方法和前向逐步似然比方法。该模型使用病例对照数据集进行了测试,并再次使用完整样本进行了测试:结果:共发现了 650 起停机事件。共分析了 22,880 个质控数据点、187 次校准、24 次能力测试事件和 107 份维护记录。使用病例对照数据,回归模型能够正确预测 59.2% 的无仪器停机事件和 69.2% 的仪器停机事件。使用整个数据集,该模型的灵敏度为 69.2%,特异度为 58.2%:逻辑回归模型可以预测近 70% 的仪器停机时间。这项研究利用化学实验室收集的有限数据集证明了这一概念。
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Comparison of basic lymphocyte phenotype results between a diagnostic and a research laboratory. Evidence-based approach for the generation of a multivariate logistic regression model that predicts instrument failure. Correlation of the abundance of MDSCs, Tregs, PD-1, and PD-L1 with the efficacy of chemotherapy and prognosis in gastric cancer. Correction to: The utility of an algorithm based on procalcitonin monitoring in patients with sepsis. Implementing laboratory internal audit to improve compliance and quality of care in the municipal public health system-based ambulatory care health clinics in New York city.
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