Reproducibility (precision) in alternate site testing. A clinician's perspective

Abstract

Problem considered: Reproducibility is only one dimension of test quality to be considered when evaluating the utility of a test or deciding to perform a test at or near the point of care.

Methods: Personal experience and review of the literature.

Results: Hemoglobin A1c and bedside glucose measurements are cited as examples in which a clinician may weigh the importance of precision differently. These examples are used to point out how precision should be considered in evaluating alternate site testing methodology.

Conclusions: The importance of analytic precision to the clinician, and whether precision can be compromised for improvement of another dimension of test quality, depends on the context in which the result of the test is to be used. In addition to the purpose of the test, the level of precision required also depends on the patient population, the particular application of the test, and how the clinician interprets the test. Clinically relevant goals for test accuracy must be individualized for each test and application. Precision may be sacrificed for lower cost, increased availability, or faster turnaround time. Collaboration between laboratorians and clinicians is essential for optimal utilization of laboratory services.