Background. Although the automation of instruments has reduced the variability of results and errors of analysis, in some laboratories, repeating a test to confirm its accuracy is still performed for critical and noncritical results. However, the importance of repeat testing is not well established yet, and there are no clear criteria for repeating a test. Materials and Methods. In this cross-sectional study, all repeated tests for 26 biochemical analytes (i.e., albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), bilirubin total (BT), bilirubin direct (BD), blood urea nitrogen (BUN), calcium, chloride (Cl), cholesterol total (CholT), creatine kinase (CK), creatinine (Cr), glucose, gamma-glutamyl transferase (GGT), high-density lipoprotein-cholesterol (HDL-c), iron, lactate dehydrogenase (LDH), LDL-c, lipase, magnesium (Mg), phosphorus (Ph), protein total (ProtT), total iron binding capacity (TIBC), triglyceride (TG), and uric acid) were assessed in both critical and noncritical ranges over two consecutive months (routine subjective test repeats in the first month and rule-based repeats in the second month). To determine the usefulness of test repeats, differences between the initial and verified results were compared with the allowable bias, and repeat testing was considered necessary if it exceeded the allowable bias range. All causes of repeat testing, including linearity flags, delta checks, clinically significant values, and critical values, were also documented. All data, including the cause of repeats, initial and verified results, time, and costs in the two consecutive months, were transferred to Microsoft Excel for analysis. For comparison of data between the months, Student’s t-test was used. Results. A total of 7714 repeat tests were performed over two consecutive months. Although a significant decline (38%) was found in repeated tests in the second month ( < 0.001), there was no significant change in the percentage of unnecessary repeats (77% in the first month and 74% in the second month). In both consecutive months, AST and ALT were the most commonly repeated tests, and delta check was the most common cause of repeat testing. Mg, ALP, AST, and lipase showed the highest rates of necessary repeats, respectively (the least stable tests), while albumin, LDL, and CholT tests showed the highest rates of unnecessary repeats, respectively (the most stable tests). The total cost and delay in turnaround time (TAT) due to repeated testing decreased by 32% and 36%, respectively. Conclusion. Although repeat testing has been shown to be unnecessary in most cases, having a strict policy for repeat testing appears to be more valuable than avoiding it completely. Each laboratory is advised to establish its own protocol for repeat testing based on its own practice.

中文翻译：

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根据实践指南终止化学实验室重复检测：检查移植中心基于规则的重复检测的效果

背景。尽管仪器的自动化降低了结果的可变性和分析的错误，但在一些实验室中，仍然对关键和非关键结果进行重复测试以确认其准确性。然而，重复测试的重要性尚未完全确定，并且没有明确的重复测试标准。材料和方法. 在这项横断面研究中，对 26 种生化分析物（即白蛋白、碱性磷酸酶 (ALP)、丙氨酸氨基转移酶 (ALT)、淀粉酶、天冬氨酸氨基转移酶 (AST)、总胆红素 (BT)、直接胆红素 (BD) , 血尿素氮 (BUN), 钙, 氯化物 (Cl), 总胆固醇 (CholT), 肌酸激酶 (CK), 肌酐 (Cr), 葡萄糖, γ-谷氨酰转移酶 (GGT), 高密度脂蛋白胆固醇 (HDL) -c)、铁、乳酸脱氢酶 (LDH)、LDL-c、脂肪酶、镁 (Mg)、磷 (Ph)、总蛋白质 (ProtT)、总铁结合力 (TIBC)、甘油三酯 (TG) 和尿酸) 在连续两个月的关键和非关键范围内进行了评估（第一个月重复常规主观测试，第二个月重复基于规则的测试）。为了确定测试重复的有用性，将初始结果和验证结果之间的差异与允许偏差进行比较，如果超出允许偏差范围，则认为有必要进行重复测试。重复测试的所有原因，包括线性标志、增量检查、临床显着值和临界值，也都记录在案。所有数据，包括重复的原因、初始和验证结果、时间和连续两个月的成本，都被转移到 Microsoft Excel 进行分析。为了比较月份之间的数据，Student's 所有数据，包括重复的原因、初始和验证结果、时间和连续两个月的成本，都被转移到 Microsoft Excel 进行分析。为了比较月份之间的数据，Student's 所有数据，包括重复的原因、初始和验证结果、时间和连续两个月的成本，都被转移到 Microsoft Excel 进行分析。为了比较月份之间的数据，Student's使用了t检验。结果。连续两个月共进行了 7714 次重复测试。尽管在第二个月的重复测试中发现了显着下降（38%）（ < 0.001），不必要重复的百分比没有显着变化（第一个月为 77%，第二个月为 74%）。在连续两个月中，AST 和 ALT 是最常见的重复测试，而 delta 检查是重复测试的最常见原因。Mg、ALP、AST 和脂肪酶分别显示出最高的必要重复率（最不稳定的测试），而白蛋白、LDL 和 CholT 测试分别显示出最高的不必要重复率（最稳定的测试）。重复测试导致的总成本和周转时间 (TAT) 延迟分别降低了 32% 和 36%。结论. 尽管在大多数情况下重复测试已被证明是不必要的，但制定严格的重复测试政策似乎比完全避免更有价值。建议每个实验室根据自己的实践建立自己的重复测试协议。