Visualization of Critical Limits and Critical Values Facilitates Interpretation.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2025-03-02 DOI:10.3390/diagnostics15050604
Ania Shah, Jenna Dohner, Kaifeng Cheng, Maria Garcia, Gerald J Kost
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Abstract

Background/Objectives: This study aimed to analyze critical limit and critical value test lists from major US medical centers, identify changes in quantitative critical limit thresholds since 1990, document notification priorities for qualitative and new listings, and visualize information alongside clinical thresholds and pathophysiological trends. Methods: A systematic search was conducted, acquiring 50 lists of critical limits and critical values from university hospitals, Level 1 trauma centers, centers of excellence, and high-performing hospitals across the US. Lists were obtained through direct contact or web-accessible postings. Statistical analysis used the Kruskal-Wallis non-parametric test and Student's t-test to determine significant differences between 1990 and 2024 critical limits. Results: Statistically significant differences were identified in various clinical tests between 1990 and 2024, comprising glucose, calcium, magnesium, CO2 content, blood gas parameters, hematology, and coagulation tests. Ranges for critical limits narrowed for several tests, and new measurands were added. Cardiac biomarkers were infrequently listed. Point-of-care testing (POCT) listings were sparse and showed significant differences from main lab values in the high median critical limit for glucose Conclusions: Visualizing this information has potential benefits, including ease of interpretation, which can improve patient care, reduce inconsistencies, and enhance the efficiency and quality of healthcare delivery.

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背景/目标:本研究旨在分析来自美国主要医疗中心的临界极限和临界值检验清单,确定自 1990 年以来定量临界极限阈值的变化,记录定性和新列表的通知优先级,并将信息与临床阈值和病理生理学趋势一起可视化。方法:我们进行了系统性搜索,从全美的大学医院、一级创伤中心、卓越中心和高绩效医院获取了 50 份临界值和临界极限值列表。名单通过直接联系或网络发布获得。统计分析采用 Kruskal-Wallis 非参数检验和学生 t 检验来确定 1990 年和 2024 年临界值之间的显著差异。结果:在 1990 年和 2024 年之间的各种临床检测中发现了具有统计学意义的差异,包括葡萄糖、钙、镁、二氧化碳含量、血气参数、血液学和凝血检测。一些检测项目的临界值范围缩小,并增加了新的测量指标。心脏生物标记物很少被列出。床旁检测(POCT)的列表很稀少,在葡萄糖临界值中位数较高的结论方面与主要实验室值有显著差异:将这些信息可视化具有潜在的益处,包括便于解释,可改善患者护理、减少不一致性并提高医疗服务的效率和质量。
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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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