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，检验医学在分析质量方面投入了大量精力，使该医学专业成为标准化程度最高、错误率最低的医学专业之一。然而，即使是最好的分析质量也无法弥补整个测试过程的分析前或分析后阶段的错误或低质量。数据报告指南仅关注定义的数据元素，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）的习惯可能会导致信息过载。考虑到医生必须同时执行多项任务，未经过滤的数据呈现可能会增加患者风险，因为可能会忽略重要信息，否则可能会出现并列错误。由于实验室应该致力于回答临床问题，而不是提供唯一的分析结果，因此优化格式选项可能有助于提高医疗决策的有效性和效率。在这篇叙述性评论中，我们专注于实验室结果报告这一未被充分重视的主题。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替代报告格式的方法、潜在益处和局限性。我们讨论了影响变量，例如患者的类型（例如急性与慢性）、报告接收者的医学专业、参考区间的显示、呈现实验室报告的媒体或平台（打印纸，在电子健康记录系统中、在手持设备上等）、查看报告的上下文以及格式化单一报告与累积报告的困难。关于这个主题的证据，尤其是实验研究，很少见。在考虑医学影响时，实验室不仅要关注分析方面，还要关注整个测试过程，这一点至关重要。如果使用无格式表格设计导致信息过载或分散导致基本结果丢失，那么实现高分析质量可能没有多大价值。绝对需要更多的实验研究来定义指南和标准化有效和高效的报告。关于这个主题的证据，尤其是实验研究，很少见。在考虑医学影响时，实验室不仅要关注分析方面，还要关注整个测试过程，这一点至关重要。如果使用无格式表格设计导致信息过载或分散导致基本结果丢失，那么实现高分析质量可能没有多大价值。绝对需要更多的实验研究来定义指南和标准化有效和高效的报告。关于这个主题的证据，尤其是实验研究，很少见。在考虑医学影响时，实验室不仅要关注分析方面，还要关注整个测试过程，这一点至关重要。如果使用无格式表格设计导致信息过载或分散导致基本结果丢失，那么实现高分析质量可能没有多大价值。绝对需要更多的实验研究来定义指南和标准化有效和高效的报告。如果使用无格式表格设计导致信息过载或分散导致基本结果丢失，那么实现高分析质量可能没有多大价值。绝对需要更多的实验研究来定义指南和标准化有效和高效的报告。如果使用无格式表格设计导致信息过载或分散导致基本结果丢失，那么实现高分析质量可能没有多大价值。绝对需要更多的实验研究来定义指南和标准化有效和高效的报告。