Establishment and evaluation of autoverification method for urinalysis

doi:10.3877/cma.j.issn.2095-5820.2021.01.012

Abstract

Abstract:

Objective

To establish an appropriate autoverification and early warning rule for urine routine.

Methods

According to the clinical significance of the urine routine, the logical relationship between the test results and the historical review, the autoverification rules were established in the laboratory information system (PRD). After the autoverification rules were evaluated and passed, the automatic approval was enabled. And the changes in sample turnaround time (TAT) before and after using the system were compared.

Results

According to the five automatic warning rule templates, 64 automatic warning rules were established. The average trigger rule rate of urine routine is 96.7%, the automatic review and issuance report pass rate is 63.0%, the human-machine consistency is 98.7%, and the accuracy rate of the passed report is 100%, and the sample turnover time TAT is significantly shortened.

Conclusion

The establishment of this autoverification system can shorten the TAT of the urine analysis report and improve work efficiency.

Key words: Autoverification, Alert rule, Urinalysis

Lingli Xiang, Yuqin Liao, Yuchong Zhu, Junquan Liu. Establishment and evaluation of autoverification method for urinalysis[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2021, 09(01): 59-63.

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Figures/Tables 6

References 10

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规则模板	规则说明	预警示例
1、单项检测结果限值核查	单项检测结果超出限值	例：pH值≥8.5；亚硝酸盐：＋；红色报警
2、与其它检测结果趋势矛盾	违背了项目之间本应有的逻辑关系	例：尿糖：阳性，血GLU＜7.0 mmol/L；红色报警
3、与历史结果比较	历史结果与今次比对，超出限值	例：查找一周内历史结果，按照尿常规允许误差，定性项目相差1个梯度以上、阴阳性不同；对同一患者相同项目此次结果与历史结果进行比较不一致时；红色报警
4、室内质控结果核查	审批报告前需对室内质控进行审核通过	例：室内质控未审核或失控未处理；红色报警
5、多项检测阳性结果之间吻合性放行	当多项结果异常，但符合临床诊断时进行审核通过	例：尿糖：阳性，酮体：阳性，且空腹血GLU＞11.1 mmol/L时绿色通过

规则模板	规则说明	预警示例
1、单项检测结果限值核查	单项检测结果超出限值	例：pH值≥8.5；亚硝酸盐：＋；红色报警
2、与其它检测结果趋势矛盾	违背了项目之间本应有的逻辑关系	例：尿糖：阳性，血GLU＜7.0 mmol/L；红色报警
3、与历史结果比较	历史结果与今次比对，超出限值	例：查找一周内历史结果，按照尿常规允许误差，定性项目相差1个梯度以上、阴阳性不同；对同一患者相同项目此次结果与历史结果进行比较不一致时；红色报警
4、室内质控结果核查	审批报告前需对室内质控进行审核通过	例：室内质控未审核或失控未处理；红色报警
5、多项检测阳性结果之间吻合性放行	当多项结果异常，但符合临床诊断时进行审核通过	例：尿糖：阳性，酮体：阳性，且空腹血GLU＞11.1 mmol/L时绿色通过

规则模板	具体规则	未通过自动审核（例）	占比（%）
1、单项检测结果限值核查	WBC阳性，提示镜检	87	40.28
	RBC阳性，提示镜检	71	32.87
	PRO阳性，提示镜检	18	8.33
	NIT阳性，提示镜检	9	4.17
	PH>7.0，需修正SG值	3	1.39
	VC＞＋＋，请注意GLU\BIL\NIT\LEU\BLD	3	1.39
2、与其它检测结果趋势矛盾	尿糖：阳性，血GLU＜7.0 mmol/L	18	8.33
3、与历史结果比较	尿胆原历史结果不一致	4	1.85
	尿糖历史结果不一致	2	0.93
3、多项检测阳性结果之间吻合性放行	VC＞＋＋，血糖＞11.1 mmol/L，尿糖阴性	1	0.46

规则模板	具体规则	未通过自动审核（例）	占比（%）
1、单项检测结果限值核查	WBC阳性，提示镜检	87	40.28
	RBC阳性，提示镜检	71	32.87
	PRO阳性，提示镜检	18	8.33
	NIT阳性，提示镜检	9	4.17
	PH>7.0，需修正SG值	3	1.39
	VC＞＋＋，请注意GLU\BIL\NIT\LEU\BLD	3	1.39
2、与其它检测结果趋势矛盾	尿糖：阳性，血GLU＜7.0 mmol/L	18	8.33
3、与历史结果比较	尿胆原历史结果不一致	4	1.85
	尿糖历史结果不一致	2	0.93
3、多项检测阳性结果之间吻合性放行	VC＞＋＋，血糖＞11.1 mmol/L，尿糖阴性	1	0.46

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