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Errors within the total laboratory testing process, from test selection to medical decision-making – A review of causes, consequences, surveillance and solutions

Cornelia Mrazek, Martin H. Keppel, Janne Cadamuro, Elisabeth Haschke‐Becher, Hannes Oberkofler, Thomas K. Felder, Giuseppe Lippi

2020Biochemia Medica93 citationsDOIOpen Access PDF

Abstract

Laboratory analyses are crucial for diagnosis, follow-up and treatment decisions. Since mistakes in every step of the total testing process may potentially affect patient safety, a broad knowledge and systematic assessment of laboratory errors is essential for future improvement. In this review, we aim to discuss the types and frequencies of potential errors in the total testing process, quality management options, as well as tentative solutions for improvement. Unlike most currently available reviews on this topic, we also include errors in test-selection, reporting and interpretation/action of test results. We believe that laboratory specialists will need to refocus on many process steps belonging to the extra-analytical phases, intensifying collaborations with clinicians and supporting test selection and interpretation. This would hopefully lead to substantial improvements in these activities, but may also bring more value to the role of laboratory specialists within the health care setting.

Topics & Concepts

Test (biology)Process (computing)Selection (genetic algorithm)Risk analysis (engineering)Medical laboratoryComputer scienceQuality (philosophy)Health careAction (physics)MedicineManagement scienceEngineeringPathologyArtificial intelligencePaleontologyEconomic growthOperating systemQuantum mechanicsPhilosophyEconomicsEpistemologyPhysicsBiologyClinical Laboratory Practices and Quality ControlMeta-analysis and systematic reviewsHealthcare cost, quality, practices