Abstract

In laboratory medicine, much effort has been put into analytical quality in the past decades, making this medical profession one of the most standardized with the lowest rates of error. However, even the best analytical quality cannot compensate for errors or low quality in the pre or postanalytical phase of the total testing process. Guidelines for data reporting focus solely on defined data elements, which have to be provided alongside the analytical test results. No guidelines on how to format laboratory reports exist. The habit of reporting as much diagnostic data as possible, including supplemental information, may lead to an information overload. Considering the multiple tasks physicians have to do simultaneously, unfiltered data presentation may contribute to patient risk, as important information may be overlooked, or juxtaposition errors may occur. As laboratories should aim to answer clinical questions, rather than providing sole analytical results, optimizing formatting options may help improve the effectiveness and efficiency of medical decision-making. In this narrative review, we focus on the underappreciated topic of laboratory result reporting. We present published literature, focusing on the impact of laboratory result report formatting on medical decisions as well as approaches, potential benefits, and limitations for alternative report formats. We discuss influencing variables such as, for example, the type of patient (e.g. acute versus chronic), the medical specialty of the recipient of the report, the display of reference intervals, the medium or platform on which the laboratory report is presented (printed paper, within electronic health record systems, on handheld devices, etc.), the context in which the report is viewed in, and difficulties in formatting single versus cumulative reports. Evidence on this topic, especially experimental studies, is scarce. When considering the medical impact, it is of utmost importance that laboratories focus not only on the analytical aspects but on the total testing process. The achievement of high analytical quality may be of minor value if essential results get lost in overload or scattering of information by using a non-formatted tabular design. More experimental studies to define guidelines and to standardize effective and efficient reporting are most definitely needed.

摘要

在过去的几十年中，实验室医学在分析质量上投入了大量精力，这使该医学专业成为标准化程度最高，错误率最低的行业之一。但是，即使是最好的分析质量也无法补偿整个测试过程的分析前或分析后阶段中的错误或低质量。数据报告指南仅关注已定义的数据元素，这些元素必须与分析测试结果一起提供。没有关于如何格式化实验室报告的指南。报告尽可能多的诊断数据（包括补充信息）的习惯可能导致信息过载。考虑到医生必须同时执行多项任务，未过滤的数据显示可能会增加患者的风险，因为可能会忽略重要信息，否则可能会发生并置错误。由于实验室的目的应该是回答临床问题，而不是提供唯一的分析结果，因此优化格式设置选项可能有助于提高医疗决策的有效性和效率。在这篇叙述性的评论中，我们关注实验室结果报告的未被充分认识的主题。我们提供已发表的文献，重点关注实验室结果报告格式对医疗决策的影响，以及方法，潜在收益和替代报告格式的局限性。我们讨论影响变量，例如患者类型（例如急性或慢性），报告接受者的医学专业，参考间隔的显示，实验室报告的显示介质或平台（印刷）纸，在电子健康记录系统，手持设备等上），查看报告的上下文以及格式化单个报告还是累积报告的困难。缺乏关于该主题的证据，尤其是实验研究。在考虑医学影响时，实验室不仅要关注分析方面，而且要关注整个测试过程，这一点至关重要。如果通过使用非格式的表格设计而使重要的结果由于信息过载或信息分散而丢失，则实现高分析质量的价值可能微不足道。绝对需要进行更多的实验研究，以定义准则并标准化有效和高效的报告。缺乏关于该主题的证据，尤其是实验研究。在考虑医学影响时，实验室不仅要关注分析方面，而且要关注整个测试过程，这一点至关重要。如果通过使用非格式的表格设计而使重要的结果由于信息过载或信息分散而丢失，则实现高分析质量的价值可能微不足道。绝对需要进行更多的实验研究，以定义准则并标准化有效和高效的报告。缺乏关于该主题的证据，尤其是实验研究。在考虑医学影响时，实验室不仅要关注分析方面，而且要关注整个测试过程，这一点至关重要。如果通过使用非格式的表格设计而使重要的结果由于信息过载或信息分散而丢失，则实现高分析质量的价值可能微不足道。绝对需要进行更多的实验研究，以定义准则并标准化有效和高效的报告。如果通过使用非格式的表格设计而使重要的结果由于信息过载或信息分散而丢失，则实现高分析质量的价值可能微不足道。绝对需要进行更多的实验研究，以定义准则并标准化有效和高效的报告。如果通过使用非格式的表格设计而使重要的结果由于信息过载或信息分散而丢失，则实现高分析质量的价值可能微不足道。绝对需要进行更多的实验研究，以定义准则并标准化有效和高效的报告。