AN AUDIT OF SEROLOGICAL TESTS
CARRIED OUT AT CLINICAL LABORATORY OF AYUB TEACHING HOSPITAL, ABBOTTABAD
Sirajuddin Hassan Ally, Ayesha Ahmed, Ruhila Hanif*
Department of Pathology and *Biochemistry,
Background: Clinical audit is an important tool for
reviewing and improving the quality of service in clinical laboratories. Here
we present an audit of total serology test requests and the frequency of
positive tests out of these in a calendar year. Methods: This is an audit of serology tests carried out at
Microbiology section of Clinical Laboratory of Ayub Teaching Hospital,
Abbottabad. We counted all the serology test requests for the year 2004. These
tests requests were grouped month wise. The frequency of positive tests out of
the total test requests were calculated. The tests included Widal, Toxoplasma,
Brucella, Anti DNA, Anti Nuclear factor (ANF), Rheumatoid Arthritis Factor
(RAF), HIV, HBsAg, HCV, Intra Chromatographic Technique for tuberculosis
(ICT-TB), Purified Protein Derivative (PPD), Venereal Disease Research
Laboratory (VDRL) test, Anti-Streptolysin-O-test (ASOT) and pregnancy test. Results and Conclusions: This audit gives
a clear idea of trends of test requests in our hospital. It reflects accuracy
of clinicians’ judgment in some tests and failure in others, prevalence of
different diseases, seasonal variation in number of test requests for some
tests and impact of awareness campaigns on attitude of clinicians towards
certain diseases. This will help us in planning our laboratory requirements to
improve quality.
Keywords: Serology, Audit, Clinical laboratory
INTRODUCTION
‘Laboratory-clinic communication’ is fundamental in achieving and maintaining quality in laboratory services. Modern health care in this era of ‘Evidence based medicine’ has put a lot of pressure on the laboratory services too. The trend now is that laboratory medicine should follow a clinical rather than a technological logic. Appropriate test requesting and interpretation coupled with a patient-oriented vision improves the outcomes for patients, and so ensures the best cost containment strategy.1 Recently dramatic changes have occurred in the organization, number and type of tests, and role of medical laboratories in healthcare. The role of laboratory professionals has undergone a radical change, which calls for greater analytical accuracy, more stringent test selection, and interpretation of results.2 The lack of good quality research in the field not only contributes to inappropriate utilization of laboratory services but also to wasting significant resources. Evidence-based laboratory medicine tries to combat this problem by combining methods from epidemiology, biostatistics, clinical and social sciences with basic sciences to evaluate the role of investigations in clinical decision making and outcomes for patients.3 Evidence-based laboratory medicine aims to advance clinical diagnosis and management of diseases through systematic researching and disseminating generalisable new knowledge which meets the standards of critical review on clinically effective practice of laboratory investigations. The use of evidence in laboratory medicine requires systematically compiled databases of standardized and critically appraised information on the test characteristics and diagnostic accuracy of laboratory investigations.4 Service quality in medical laboratories is influenced by a number of variables. Medical laboratories have long recognized the need for total quality management that incorporates the continuous improvement of all stages, such as the pre-analytical, analytical and post-analytical phases, of the diagnostic process, in addition to the traditional internal and external quality control of analytical procedures. Based on national and international experience, continuous improvement of quality and its external assessment are of high priority in order to guarantee a reliable, effective and cost-effective diagnostic service. The process of constant questioning and reviewing the evidence for rational diagnosis of diseases provides a practical tool to identify gaps in our knowledge and thus it generates new research ideas in laboratory medicine.5Clinical audit is an important tool for reviewing and improving the quality of service in clinical laboratories. Here we present an audit of total serology test requests and the frequency of positive tests in a calendar year. This will give an idea of trends of test requests in our hospital. This will help us in planning our laboratory requirements to improve quality.
MATERIAL AND METHODS
This is an audit of serology tests carried out at
Microbiology section of Clinical Laboratory of Ayub Teaching Hospital,
Abbottabad. This laboratory caters for a 1000 bed tertiary care hospital that is
the main teaching hospital of
RESULTS
The results of this audit are summarized in
tables 1 to 5.
DISCUSSION
Serology laboratory is very important in diagnosis of
a number of diseases.