甲状腺功能检测项目自动审核系统的建立与优化

Establishment and optimization of an autoverification system for test results of thyroid function

目的建立并优化甲状腺功能检测项目自动审核系统。方法依据CLSI AUTO10-A和CLSI AUTO15,基于AptioTM生化免疫自动化流水线中间件软件进行甲状腺功能检验项目自动审核程序建立及验证,采用Delta check大数据智能分析系统进行特定学科人群统计分析及自动审核规则优化。结果细化自动审核范围、调整Delta check值以及增加甲状腺功能指标组合模式判断规则后,促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、总甲状腺素(TT4)、总三碘甲腺原氨酸(TT3)的平均通过率都在90%以上,而抗甲状腺球蛋白抗体(A-TG)和抗甲状腺过氧化物酶抗体(A-TPO)的平均通过率在70%以上,整体较之前升高了7%~17%。甲状腺功能检验结果自动审核平均通过率从84.68%上升至94.45%,升高幅度达9.77%。实验室内标本周转时间(TAT)中位数从92 min降至78 min,缩短15.2%,自动审核报告TAT中位数从70~85 min下降至60~75 min。检验报告的差错率从0.096‰(5/51976)下降至0.000‰(0/154282),报告的审核时效和准确性明显提高。结论自动审核系统的建立、验证与优化,可以减轻工作强度,缩短TAT,降低风险并提高工作效率。

Objective To establish and optimize an autoverification system for the test results of thyroid function.Methods Accord-ing to AUTO10-A and AUTO15 approved by Clinical and Laboratory Standards Institute(CLSI),the autoverification system for the test results of thyroid function was established and verified based on AptioTM automation platform.The Delta Check intelligence systemwas used for statistical analysis of specific subjects and optimize autoverification rules.Results After refining the range of autoverification,adjusting the delta check value and adding the judgment rule of thyroid function index combination mode,the average autoverification rates of TSH,FT4,FT3,TT4 and TT3 were above 90%,while the average autoverification rates of A-TG and A-TPO were above 70%,which were higher than those of previous results for 7%to 17%.The average autoverification rate of the reports increased from 84.68%to 94.45%with increase rate of 9.77%.The median turnaround time(TAT)in the laboratory was shortened by 15.2%from 92 to 78 minutes.The median TAT of autoverification for reports decreased from 70-85 minutes to 60-75 minutes.The error rate of reports decreased from 0.096‰(5/51976)to 0(0/154282),which significantly improved the autoverification effectiveness and accuracy of the test reports.Conclusion The establishment,verification and optimization of autoverification system could reduce work intensity,decrease TAT,reduce risks and effectively improve work efficiency and ensure the test quality.