Both respondents make valid points.
As highly trained and experienced scientists, we should be able to offer answers to questions when these are addressed to us by our clients in the context of patient care. If we can design an experiment with appropriate positive and negative controls which can give a valid yes/no answer or semi-quantitative result in an unusual scenario that lies outside a 'routine' procedure, then we should do so and be professionally accountable for this action.
CPA accreditation standards (the new ones) require creation, maintenance and review of an effective quality system that drives improvements in service. If we can fit this 'experiment' into the quality system, with appropriate validation and documentation, such that the action may be reproduced and subjected to quality improvement, then we satisfy CPA requirements don't we?
Best regards to all
Jonathan Middle
-----Original Message-----
From: [log in to unmask]
To: [log in to unmask]
Date: Fri, 15 Aug 2003 16:06:45 +0100
Subject: Re: interpretative case 147 and robots or not?
My comment was seeking information, as we recently carried out an anlysis on
a TPN sample, and we used another TPN sample as a control. If the laboratory
gets pulled into a legal case using the result obtained, I wondered if one
could be accused of poor laboratory practice for analysing an analyte in a
matrix that one does not have experience in, is not independently quality
controlled, and not covered by one's accreditation.
____________________________________________________________
Dr. Helen Grimes, Dept. of Clinical Biochemistry, UCH, Galway, Ireland
-----Original Message-----
From: Trevor Bianes [mailto:[log in to unmask]]
Sent: 15 August 2003 14:14
To: [log in to unmask]
Subject: interpretative case 147 and comments
I have read the discussions on this list for some years now and have been
amused, educated and amazed by what I have read.Finally, today I am
prompted to join and make a comment about the discussion on Interpretative
NEQAS 147.I declare an interest in that it was my comment that was used as
the high scoring comment ( although my comment on the previous case was
used as a low scoring comment), so this is not a case of blowing my own
trumpet ( I play viola and piano!).We had exactly this case scenario only a
few weeks before the case was posted, and I adopted a hopefully scientific
approach to answering the question posed by the clinician.Which was to
contact the lab which measures our oestradiol and testosterone and ask if
they could help. They dissolved some of the implant in saline ( we don't
have organic solvents in our bodies, so physiologically aqueous type
solvent would seem appropriate) and measured oestradiol and testosterone on
the centrifuged solution, which was positive for one and negative for the
other.We were asked a question and (rarely in Clinical Biochemistry) we
were able to answer it clearly.The application of a small amount of
scientific thought resulted in a happy clinician and patient who had the
relevant implant replaced ( and also two rather pleased clinical scientists
in two small laboratories who were pleased that they had not forgotten
everything that they were taught a number of years ago).I hope Helen Grimes
was not serious about whether we should do such things as it makes me
despondent that we may have been so CPAd,governanced and NICEd to death
that we are fast becoming Clinical Robots.I agree with Gordon's scientific
views.
UK NEQAS Birmingham
tel 0121 414 7300, fax 0121 414 1179
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