A good medical laboratory: how to define it?
How to choose the right laboratory and who can you trust with your analyzes? Let’s start with a banal advice – if you are not self-medicating, then first of all listen to the opinion of your doctor, it is he who will advise you on the right laboratory, since many patients pass through it with analyzes from different manufacturers. The doctor most often has an idea in which laboratories the analyzes agree with the clinical picture, and which ones are godlessly wrong.
If we talk about serious private companies that are engaged in laboratory diagnostics in Russia, then all of them are quite highly automated, and therefore 90% of errors occur at the preanalytical stage (from the moment the patient prepares for testing to their entry into the analyzer). In this regard, the advice – network laboratories with hundreds of branches from Moscow to Krasnoyarsk are not the best choice, all of them are equipped with automatic tube sorting stations. Since the biomaterial arrives from very remote places and sometimes even takes more than 48 hours to reach the laboratory, and a significant proportion of analyzes must be delivered to the analyzer within 12 hours after taking, the criteria for rejection of samples are deliberately underestimated. Thus, some of the results are not entirely reliable, which is confirmed by negative reviews on the Internet. In addition, sorters work more rudely than people, and therefore the share of rejection of test tubes “according to formal” criteria is high. those where the barcode is crookedly glued or the shade of the cover is slightly different from the base one, which leads to re-digging. Also, “laboratory factories” completely abandon medical validation, that is, the doctor’s review of the analyzer’s result before issuing it to the patient, at the time of searching for contradictions between various tests or the clinical picture.
A very important sign of quality laboratory work is participation in external quality assessment (EQA) programs. How do these programs work? The world’s largest manufacturers of reagents prepare standardized sera and send them to partner laboratories around the world, where doctors measure them on their equipment, and enter the data into electronic forms, if they are correct from month to month, at the end of the research cycle (usually 12 months) laboratory receives a certificate. “Gold Standard” – EQAS EQAS program from Biorad company, participating laboratories post certificates on their websites. Please note that certificates must be renewed annually.
The next advice follows from the previous one, we do not recommend taking tests in medical centers that have their own laboratories or laboratories of municipal and departmental clinics, EQA programs cost decent money. It is unprofitable for medical centers with less than a hundred samples per day, and the state does not allocate money for EQA to municipalities.
Another reason why, as a rule, the quality of analyzes in state institutions is lower – lower salaries of staff, and as a result, lower qualifications, and in the regions it is often also the inability to work on reagents that are “native” for analyzers.
Choosing a laboratory is not easy, and it is necessary to treat this process in the same way as the process of choosing a doctor. You don’t go to the specialist who sits in the next doorway for treatment, or to the one who asks for an appointment least of all in the city? The main goal of the patient passing the tests is to get a reliable result, and therefore, when choosing a laboratory, it is not the proximity of the medical office and its prices that are important, but the qualifications of the laboratory personnel, medical validation, participation in external quality assessment, and modern equipment operating on original reagents. To form an opinion about such qualities of laboratories, you can rely on the opinion of the attending physicians, laboratory sites on the Internet, and patient reviews about reboots and the quality of the results.