ABSTRACT
BACKGROUND: A Spanish multicentre evaluation of the third generation of Roche Diagnostics immunoturbidimetric inhibition method (TINIA) is presented for quantification of haemoglobin A1c (HbA1c) in whole blood. METHODS: The analytical performance of the TINIA test was evaluated and blood sample results were compared with two other widely used analysers, Bio-Rad Variant II and Adams Arkray HA-8160, based on HPLC. RESULTS: Within- and between-batch imprecision (coefficients of variation (CVs)) for HbA1c levels of 5, 6, 7 and 8% were 0.77, 1.23, 1.35 and 1.26% and 2.38, 1.51, 1.76 and 2.16%, respectively. For low (5.4% A1c) and high (10.1% A1c) quality control samples, the within and between-batch %CV were: 1.26; 1.43 and 2; 1.71 respectively. The test met the expected performance in most aspects, except for linearity, that is under the reported range, and HbF interferences, detected for levels over 7.5%. There was a good concordance between the results of TINIA and Variant-IIt in the whole range and with HA-8160 only up to levels of 9%. Between-batch imprecision suggests more frequent calibrations than reported by the provider to maintain variability within the limits established by clinical practice guidelines. CONCLUSIONS: The assay meets the necessary quality standards for routine use, as long as we keep the analytical variability within narrow limits. The results may be interchangeable with the tested HPLC systems, but HbF interference is not detected and it happens at lower levels than reported.
Subject(s)
Glycated Hemoglobin/metabolism , Chromatography, High Pressure Liquid , Humans , Reproducibility of Results , SpainABSTRACT
Introducción. El objetivo ha sido describir y evaluar un nuevo protocolo de comunicación de resultados críticos aplicado a Microbiología en un Área Sanitaria de Andalucía. Material y métodos. Se analiza el tamaño y tipo de los valores críticos de Microbiología para pacientes de Atención Primaria. Se evaluó un nuevo sistema de notificación informatizado, a tiempo real, a través de la Historia Digital de Salud Diraya, que integra el módulo de pruebas analíticas (MPA). Dicho protocolo se complementa, en colaboración con la tecnología de la información (TI), con el servicio de mensajes cortos (SMS) "WebMovil" de la Junta de Andalucía. Resultados. El número total de avisos de resultados críticos por el nuevo protocolo en el año 2012 fue de 817. El número de valores críticos para Atención Primaria fue de 570, de los cuales 90 fueron de Microbiología. El aviso más frecuente fue por aislamiento en el coprocultivo (n=51; 56,67 %). La prevalencia de los valores críticos de Microbiología en Atención Primaria fue de 0,45/100. El tiempo promedio de notificaciones fue de 13 minutos. La tasa de éxito de las notificaciones ha sido del 97,7 % y se obtuvo un 0% de abandonos. En el 99,93% de los casos se constató el contacto con el enfermo, y en el 98,55% la actuación médica. Conclusiones. La comunicación por un sistema informatizado unida a la tecnología SMS demostró una reducción en el tiempo de notificación y produjo beneficios adicionales, como eliminar el riesgo de errores cuando por parte del receptor no hay una repetición de la información recibida por el laboratorio. Además, el uso de mensajes SMS asegura que a los médicos de guardia siempre les llegue la información de una forma inmediata (AU)
Introduction. The objective was to describe and evaluate a new communication protocol of reporting critical results applied to Microbiology in a health area of Andalusia. Material and methods. The size and type of the critical values of Microbiology are analyzed for primary care patients. A new computerized reporting system was analyzed, in real time, through Diraya Digital Health Records, which integrates the analytical test module (MPA). The protocol is complemented, in collaboration with the Information Technology (IT), with the Junta de Andalucía short message service (SMS) "WebMovil". Results. The total number of notices of critical results by the new protocol in 2012 was 817. The number of critical values for primary care was 570, of which 90 were for Microbiology. The most frequent notice was by isolation in the stool culture (n = 51; 56.67%). The prevalence of the critical values of Microbiology in primary care was 0.45/100. The average time of notifications was 13 minutes. The success rate of notifications was 97.7% and 0% obtained in the number of withdrawals. In 99.93% of cases the contact with the patient was stated and in 98.55% the medical intervention was also confirmed. Conclusions. Communication by a computerized system linked to the SMS technology showed a reduction in the time of notification, and produced additional benefits, such as eliminating the risk of error when there is no repetition of information from the recipient received by the laboratory. Furthermore, the use of SMS messages ensures that doctors on duty always receive information immediately (AU)
Subject(s)
Humans , Medical Records , /organization & administration , Electronic Prescribing , Forms and Records Control/organization & administration , Patient Safety , Clinical Pharmacy Information Systems/organization & administration , Adverse Drug Reaction Reporting Systems/organization & administrationABSTRACT
Introducción. El objetivo ha sido describir y evaluar un nuevo protocolo de comunicación de resultados críticos en un Área Sanitaria de Andalucía. Material y métodos. Se analiza el tamaño y tipo de los valores críticos del Área Sanitaria para pacientes de Atención Primaria. Se evaluó un nuevo sistema de notificación informatizado, a tiempo real, a través de la Historia Digital de Salud Diraya, que integra el módulo de pruebas analíticas (MPA). Dicho protocolo se complementa en colaboración con la tecnología de la información (TI), con el servicio de mensajes cortos (SMS) «WebMovil» de la Junta de Andalucía. Resultados. Los valores críticos para los pacientes de Atención Primaria representan el 26,33% del total. El número total de valores críticos para Atención Primaria fue de 138 desde noviembre 2010 a septiembre 2011. El aviso más frecuente fue por hemoglobina baja (52,17%). El tiempo promedio de notificaciones fue de 13 min. La tasa de éxito de las notificaciones ha sido del 95,7% y se obtuvo un 0% de abandonos. En el 99,93% de los casos se constató el contacto con el enfermo y en el 98,55% la actuación médica. Conclusiones. La comunicación por un sistema informatizado unida a la tecnología SMS demostró una reducción en el tiempo de notificación y produjo beneficios adicionales, como eliminar el riesgo de errores cuando por parte del receptor no hay una repetición de la información recibida por el laboratorio. Además, el uso de mensajes SMS asegura que a los médicos de guardia siempre les llegue la información de una forma inmediata(AU)
Introduction. To describe and evaluate a communication protocol of critical results in the context of primary care in Health Management Area. Material and methods. We analyze the size and type of critical values of the Health Care Area for outpatient patients. We evaluated a computerized reporting system, in real-time through Diraya Digital Health Records, which is the management and information system for health management in Andalusia and integrates the Analytical Test Unit (MPA), in connection with the Laboratory Information System (LIS). This protocol is complemented, in collaboration with the information technology (IT), by the Andalusion Regional Government Short Message Service Mobile Web (SMS), «WebMovil». Results. Critical values for primary care patients represent about the 26.33% of the total. The most common notice was for low hemoglobin (52.17%). The total number of critical values for primary care was 138. The average time of notification by the new protocol was 13 minutes. The success rate of notifications was 95.7%, and those for abandonments 0%. In 99.93% of the cases contact was made with the patient, and medical action was taken in 98.55% of the cases. Conclusions. The communication by a computerized system linked to SMS technology showed a reduction in the time of notification and produced additional benefits, such as eliminating the risk of errors when the step of repetition by the receiver is not used. Furthermore, the use of SMS ensures that doctors on-call will always get the information immediately(AU)
Subject(s)
Humans , /organization & administration , Primary Health Care/methods , Primary Health Care/organization & administration , Primary Health Care , Information Technology/methods , Information Technology/prevention & control , Information Technology/analysis , Information Technology/statistics & numerical data , Disease Notification/methods , Disease Notification/standards , Notification , Patient Safety/statistics & numerical data , Patient Safety/standardsABSTRACT
AIMS: To analyze the seasonal variations in A1c levels among a southern European diabetic population. METHODS: We examined all monthly-grouped A1c determinations from diabetic patients during the period 2006-2011, in a region of southern Spain. RESULTS: There were 61,329 records available. The mean A1c value was 56mmol/mol (7.2%±1.7%) (95% CI, 55-56mmol/mol (7.2%-7.3%), with a range of 0.2%. The highest value was in February and the lowest in July (56mmol/mol (7.3%) and 54mmol/mol (7.1%), respectively) (P<0.01). However, spectral analysis and correlation coefficients did not reach significance, and the series presented no seasonal pattern. CONCLUSIONS: In our area, although the A1C levels have some monthly fluctuation they show no significant seasonal pattern. Thus, the seasonal fluctuation of HbA1c is not a limitation for decision making in clinical practice.
