Decentralized Clinical Chemistry Testing: Quality of Results Obtained by Residents and Interns in an Acute Care Setting

Abstract

We evaluated the quality of results obtained for near- patient testing by residents and interns (MDs) using desk-top analyzers. The instruments evaluated were the Reflotron analyzer, the Seralyzer, the Vision analyzer, and the Kodak DT60 analyzer. Low- and high-concen trations of control materials were used for precision studies. Results obtained by MDs were compared with those obtained by a trained technologist for comparison studies. The range of precision obtained by MDs was 4.6 to 6.6% for the Reflotron analyzer, 3.6 to 20.7% for the Seralyzer, 1.7 to 5.3% for the Vision analyzer, and 2.7 to 13% for the Kodak DT60 analyzer. The range of correla tion coefficients for each of the analyzers was 0.980 to 0.994 for the Reflotron analyzer, 0.763 to 0.933 for the Seralyzer, 0.989 to 0.999 for the Vision analyzer, and 0.987 to 0.999 for the Kodak DT60. The percentage of results for each of the analyzers when the results ob tained by MDs were more than 10% different from the trained technologist's results were 17.3% for the Reflo tron, 44% for the Seralyzer, 0% for the Vision, and 17% for the Kodak DT60. The discrepancies between MD and the trained technologist's results are related to the complexity of the instruments used.