Dear Dr Kallner,
The discussion on MU with Mr Minett has been very interesting.
From this discussion, how would you measure and calculate MU for an
Intensive Care doctor who had the choice of having sodium results measured
on either a blood gas analyser in the ward or on a routine analyser in the
lab, with Na results being measured on both devices at different times for
any particular patient?
Kind regards,
Michael Peake,
Recently retired,
Flinders Medical Centre,
Adelaide,
South Australia,
Australia.
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Anders Kallner
Sent: Saturday, 23 January 2010 7:11 PM
To: [log in to unmask]
Subject: Uncertainty
Dear Mr Minett,
True, but I think we are talking about slightly different things.
In my letter I only described a rational way to estimate the
uncertainty of measurements in a particular conglomerate of
instruments. The coverage factor is used to modify the probability
that the best estimate is within the coverage limits. The best
estimate itself is the mean of the observations and a weighted mean is
preferable if there are different numbers of observations carried out
by the different instruments. How you use the estimated uncertainty is
another cup of tea and it fits into the Westgard rules as well as any
other estimate. You should realize that the original idea was to set
the alarm limit to +/-2 SD but this will increase the number of false
alarms beyond what most laboratories accept and 2.3 or 2.5 SD are
frequently advised and should be included in your power functions. The
power functions is a balance between false rejects and false accepts -
as usual.
All these aspects have been nicely described by Callum Fraser in
Dundee and Per Hyltoft Petersen in Odense (Denmark) - just across the
North Sea.
Enjoy the weekend!
Anders Kallner
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