Variability of reporting and lack of adherence to consensus guidelines in human T-lymphocyte immunophenotyping reports: results of a case series

Article Abstract:

Most clinical laboratories may not follow all of the proposed guidelines for reporting T-lymphocyte immunophenotyping (TLI) results. These guidelines were developed by the National Committee for Clinical Laboratory Standards (NCCLS).TLI involves counting T cells and their subsets to determine if the counts fall within normal ranges. A study compared reports of TLI results from 13 laboratories to the proposed NCCLS guidelines. The reports contained a wide variety of information, and most laboratories followed some of the NCCLS guidelines. The date and time of sample collection were recorded on only 54% of the reports. Only 62% contained the time at which the sample was received in the testing laboratory. None of the laboratories measured all of the subsets of T-lymphocytes specified by the NCCLS guidelines. Sixty-two percent of the laboratories included interpretative comments on the reports, but the content of these comments varied widely.

Reports, Measurement, HIV infection, HIV infections, T cells, Reference values (Medicine)

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Reporting the results of human immunodeficiency virus testing

Article Abstract:

Laboratories sometimes report test results for the AIDS (acquired immunodeficiency syndrome) virus incorrectly or in a confusing manner. To investigate this phenomenon, sets of three blood samples were sent to several labs as if they were routine patient samples. Sample A was positive for antibodies to HIV (human immunodeficiency virus), a sign that the virus itself was present. Sample B was negative for HIV. Sample C gave a false positive result (report as positive when it is actually negative) if certain types of tests were used. Half the laboratories reported sample A as indeterminate, although one facility eventually reported it positive without use of further tests. The report forms returned by the laboratories often obscured the actual results by surrounding them with other information. This additional information was sometimes wrong, for example misidentifying the virus tested for as HTLV-III, a virus similar to the AIDS virus.

Case studies, Diagnostic errors, Immunologic diseases, HIV antibodies

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Variation in proficiency testing performance by testing site

Article Abstract:

Many traditional clinical laboratories appear to have a better performance record than newer, non-traditional labs. Traditional labs include hospital and independent labs while non-traditional labs are found in doctors' offices, nursing homes, community clinics and rehabilitation facilities. The 1994 proficiency tests of 17,058 labs were analyzed. During these tests, the labs must accurately measure specific chemicals in specimen samples. In 1994, 97% of the traditional labs performed accurately, compared to 91% of the non-traditional labs. Non-traditional labs were almost three times more likely to have an unsatisfactory performance.

Evaluation, Testing, Performance (Law)

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