REPRODUCIBILITY (PRECISION) IN ALTERNATE SITE TESTING - A CLINICIAN PERSPECTIVE

Problem Considered.-Reproducibility is only one dimension of test qual ity 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 exp erience and review of the literature. Results.-Hemoglobin A(k) and bed side glucose measurements are cited as examples in which a clinician m ay weigh the importance of precision differently. These examples are u sed to point out how precision should be considered in evaluating alte rnate site testing methodology. Conclusions.-The importance of analyti c 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 lever 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. Pr ecision may be sacrificed for lower cost, increased availability, or f aster turnaround time. Collaboration between laboratorians and clinici ans is essential for optimal utilization of laboratory services.