An evaluation of the necessity of repeat testing of critical and dangerous values in a medical center in Taiwan.

Abstract

Introduction: Routine repeat testing of critical laboratory values delays reporting, and its effectiveness lacks empirical evidence. This study investigated the impact of automated repeat testing on report accuracy and timeliness.

Methods: This retrospective study of data from a large accredited medical center in Taiwan analyzed the occurrence rate, relative frequency, differences in repeat testing, and reporting delays of critical and dangerous values. Acceptable difference criteria were based on measurement uncertainty or College of American Pathologists criteria. Differences greater than the acceptable difference criteria were defined as "large differences."

Results: The occurrence rates of critical and dangerous values were 0.15% and 0.23%, respectively, with an acceptable difference rate of 99.57%. Large differences occurred at 0.39% (within the analytical measurement range [AMR]), 7.69% (above the AMR), and 0% (below the AMR). Repeated testing caused a median reporting delay of 10 to 33 minutes.

Discussion: Repeat testing within the AMR is unnecessary. Values above the AMR require repeat testing, whereas values below the AMR warrant investigation of preanalytical errors. Targeted repeat testing policies can reduce reporting times, minimize reagent waste, and enhance patient safety.