Factors Affecting Quality of Laboratory Result During Ordering, Handling, and Testing of the Patient's Specimen at Hawassa University College of Medicine and Health Science Comprehensive Specialized Hospital

A pilot study of non-invasive diagnostic tools to detect Helicobacter pylori infection and peptic ulcer disease

Helicobacter pylori (H. pylori) infection can lead to various digestive system diseases, making accurate diagnosis crucial. However, not all available tests are equally non-invasive and sensitive. This study aimed to compare the efficacy of non-invasive and invasive diagnostic tools for H. pylori infection and assess their correlation with esophagogastroduodenoscopic (EGD) findings. The study utilized the Campylobacter-Like Organism (CLO) test, serum anti-HP IgG blood test, and C-13-urea breath test (UBT) to diagnose H. pylori infection. A total of 100 patients with peptic ulcer symptoms, including 45 males and 55 females, were recruited for the study. Symptomatic patients between the ages of 20-70, eligible for EGD examination, were enrolled. Each diagnostic test and any combination of two positive tests were considered the reference standard and compared against the other diagnostic methods. Additionally, the relationship between these diagnostic tests and EGD findings was evaluated. Among the participants, 74.0% were diagnosed with peptic ulcer disease through EGD. The UBT demonstrated the highest Youden's index, ranging from 58 to 100%, against all the non-invasive tests. The IgG blood test displayed the highest sensitivity at 100%, with a specificity of 60-70%. On the other hand, the CLO test exhibited the highest specificity at 100% and a sensitivity of 50-85%. Furthermore, only the CLO test showed a significant association with esophageal ulcers (p-value = 0.01). The IgG blood test holds promise as a primary screening tool due to its exceptional sensitivity. While the UBT is relatively expensive, its non-invasive nature and high sensitivity and specificity make it a potential standalone diagnostic test for H. pylori infection. Moreover, the noteworthy negative correlation between the CLO test and esophageal ulcers provides evidence of the differing effects of H. pylori infection on antral-predominant and corpus-predominant gastritis.

Designing a minimum data set of laboratory data for the electronic summary sheet of pediatric ward in Iran: A cross-sectional study

Background and Aim

Iranian hospitals are provided with hospital information systems (HISs) from different vendors, which make it hardly possible to summarize laboratory data in an consistent manner. Therefore, there is a need to design a minimum data set of laboratory data that will define standard criteria and reduce potential medical errors. The purpose of this study was to design a minimum data set (MDS) of laboratory data for an electronic summary sheet to be used in the pediatric ward of Iranian hospitals.

Methods

This study consists of three phases. In the first phase, out of 3997 medical records from the pediatric ward, 604 summary sheets were chosen as sample. The laboratory data of these sheets were examined and the recorded tests were categorized. In the second phase, based on the types of diagnosis we developed a list of tests. Then we asked the physicians of the ward to select which ones should be documented for each patient's diagnosis. In the third phase, the tests that were reported in 21%-80% of the records, and were verified by the same percentage of physicians, were evaluated by the experts' panel.

Results

In the first phase, 10,224 laboratory data were extracted. Of these, 144 data elements reported in more than 80% of the records, and more than 80% of experts approved them to be included in the MDS for patients' summary sheet. After data elements were investigated in the experts' panel, 292 items were chosen for the final list of the data set.

Conclusions

This MDS was designed such that, if implemented in hospital information systems, it could automatically enable registering data in the summary sheet when patient's diagnosis is registered.

Taking a step back from testing: Preanalytical considerations in molecular infectious disease diagnostics

Recent studies evaluating the preanalytical factors that impact the outcome of nucleic-acid based methods for the confirmation of SARS-CoV-2 have illuminated the importance of identifying variables that promoted accurate testing, while using scarce resources efficiently. The majority of laboratory errors occur in the preanalytical phase. While there are many resources identifying and describing mechanisms for main laboratory testing on automated platforms, there are fewer comprehensive resources for understanding important preanalytical and environmental factors that affect accurate molecular diagnostic testing of infectious diseases. This review identifies evidence-based factors that have been documented to impact the outcome of nucleic acid-based molecular techniques for the diagnosis of infectious diseases.

Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia

Background

Currently, more than two-thirds of medical decisions are made based on laboratory test results. However, due to the compromised pre-analytical and post-analytical phases (or extra-analytical phase), the reporting of incorrect or inappropriate test results was still prevalent. Studies focusing on the prevalence of and factors associated with laboratory error remain very limited in Ethiopia.

Objective

This study aimed to assess the magnitude of extra-analytical errors and associated factors in medical laboratory services in 13 public hospitals in Addis Ababa, Ethiopia, from January to April 2020.

Materials and Methods

A hospital-based cross-sectional study was conducted in the medical laboratories of public hospitals in Addis Ababa from January to April 2020 to assess extra-analytical errors and associated factors. Data were collected from 2401 laboratory request forms ordered within the study period and 169 laboratory professionals working in public hospitals. The collected data were entered and analyzed using SPSS version 23 software. Data were analyzed using simple descriptive statistics, percentages, and frequencies and summarized using tables and text. Bivariate logistic regression analysis was conducted, and variables (with a p value below 0.25) were included in the multivariate logistic regression model. A p value <0.05 was considered a cutoff point in the final model.

Results

In this study, of the errors detected, 60.3% occurred in the pre-analytical phase and 39.7% in the post-analytical phase. Extra-analytical errors in laboratory services were significantly associated with lack of written procedures for laboratory activities (adjusted odds ratio = 2.79, 95% confidence interval = 1.34-5.86), 1-2 years of work experience (adjusted odds ratio = 5.5, 95% confidence interval = 2.54-9.31), work experience (3-5 years) (adjusted odds ratio = 2.67, 95% confidence interval = 0.94-4.56), and education (diploma) (adjusted odds ratio = 6.30, 95% confidence interval = 2.17-12.26).

Conclusion

This study discovered errors in the pre-analytical (60.3%) and post-analytical (39.7%) phases, and none of the requisition papers had complete data. This frequency may be affected by workload, a lack of written procedures, the number of years of work experience, and the level of education of the staff.