Biomedical subjects
Publications and source records attributed to A F Krieg.
The CAP Laboratory Computer Applications and Data Processing Committee surveyed recently a random sample of participants in the CAP Survey Program to determine the current status of data processing in clinical laboratories. The results of the study, which confirm that laboratory computerization is a still new but growing movement, are presented in the following pages.
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1. The EMIT-AED procedures for phenobarbital and diphenylhydantoin have been adapted for use on the ABA-100. 2. A basic language computer program has been developed for data reduction and quality control. 3. Within-run and run-to-run coefficients of variations were, in general, less than 8% across the concentration range tested. 4. Performance data on agreement of duplicates and recovery from "spiked" samples were aceptable. 5. The automated procedure provides a two-thirds savings in reagents.
The authors have developed a system that provides information about costs related to specific laboratory tests. These costs are derived from: (1) labor and material actually used for specific tests; (2) allocation of costs for labor and material shared by several different tests; (3) allocation of supervisory and management costs. The "cost" of a specific procedure is a theoretical construct that is significantly affected by the method chosen for allocation. We know of no cost-analysis system generally accepted by all clinical laboratories. Since third-party payers may base future reimbursement on costs rather than charges, accurate systems for clinical laboratory cost analysis may have some practical value.
A mathematical model depicting operation of a blood-gas workstation was developed by two systems analysts working closely with two clinical pathologists. This model was used to provide estimates of average as well as maximum turnaround times under various conditions of workload, specimen types (capillary vs. syringe), methodology (use of IL 513 vs. IL 313 for capillary samples), and reporting procedures (report each sample as analyzed vs. report after analysis of all samples in batch). These estimates have been validated against actual experience in our laboratory. Such an objective mathematical model can be used to plan optimal service.
A new thyroid hormone index, based on measurements of thyroxine (T4), triiodothyronine (T3) and resin uptake (RT3U), is proposed. In contrast to previous thyroid hormone indices, it incorporates both T3 and T4 measurements. This combined thyroid hormone index appears to have superior predictive value in terms of clinical correlation with thyroid disease.
This article describes a simple method for summarizing total activity from the worksheets used at each workstation in a clinical laboratory. Monthly reports display day-to-day trends in total workload, as well as changes in the ratio between charged and total tests. Cumulative summaries of the monthly reports display month-to-month trends of total workload, as well as the ratio between charged and total tests. These reports also provide: (1) a simple method to calculate "lost revenue" (difference between total "chargeable" work and credited revenue); (2) more rapid and more uniform calculation of CAP workload units. In the author's laboratory, time required to maintain this data base and calculate CAP workload units has been less than the time previously required for calculation of CAP workload units alone.
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An improved micromethod for plasma fibrinogen, based on the Ellis-Stransky thrombin-clot density procedure, is presented. Modifications includes: (1) addition of Polybrene eliminates heparin interference; (2) measurement of absorbance at 340 nm provides improved sensitivity at low fibrinogen levels as well as with small volumes of plasma (40 mul.); (3) higher concentration of thrombin reduces the incubation time. Plasma fibrinogen by the proposed method compares well with a reference procedure based on total clottable protein (coefficient of correlation 0.99).
We describe a single-reagent, enzymatic procedure for triglycerides in serum, which may be performed in 5 min per sample with use of an Abbott ABA-100 analyzer system. This procedure is compared to the semi-automated enzymatic procedure with the ABA-100, which requires 30 min per sample.
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