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The random measurement of the transverse diameter of the fetal heart: a potential source of error.

In a recent report it was suggested that the transverse diameter of the fetal heart measured randomly during the cardiac cycle from the real-time image was useful in predicting congenital heart disease (Jeanty P, Romero R, Cantraine F, et al: Fetal cardiac dimensions: a potential tool for the diagnosis of congenital heart disease. J Ultrasound Med 3:359, 1984). Comparing the above approach with M-mode measurements at end-diastole and end-systole suggests that random measurement of the transverse diameter is not appropriate for fetal cardiovascular evaluation because it could predict over 40 per cent of normal fetuses to have an "abnormally" increased cardiac dimension.

Echocardiography↗

Inadequate cell washing as a source of error in fetal hemoglobin determination.

Washing the red cells before preparation of the hemolysate is important in avoiding serious clinical errors in fetal hemoglobin determinations. This has been demonstrated using both the alkali denaturation technique and a commercial hemolyzing reagent. Hemolysates prepared from unwashed cells were always above the normal range in samples known to be normal.

Cytological Techniques↗

Filter paper as a source of error in the determination of nitrite in meat.

Samples of filter paper were found which contain sufficient nitrite to cause significant error in determining the nitrite content of cured meat products by the official AOAC method. Six of 28 boxes of filter paper examined were contaminated with nitrite. All 6 contaminated boxes were the same brand and grade. These samples of filter paper could contribute from 4.6 to 18.4 ppm nitrite to the amount of nitrite analyzed for in meat.

Filtration↗

[Sources of error in clinical practice].

The clinical setting is everything that contact us with the patient's reality, including physical, instrumental and laboratory exploration, and we use it for diagnostic and treatment purposes. Diagnosis is the synthesis by which physicians conclude an elaborated analysis of subjective and objective data, obtained by physical exam and technology. This procedure involves data collection about the patient and his disease, the results of various tests and laboratory findings, the interpretation of the data and a diagnostic summary. Medical errors may be derived from insufficiency in any of these phases. It is evident that technology will never replace the intellectual data recollection, analysis and reasoning that is the physician's art. This contribution underlines some of the defects frequently observed in clinical practice that may cause medical errors.

Humans↗