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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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IMPACT FACTOR 2016: 3.432

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1437-4331
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Volume 44, Issue 4 (Apr 2006)

Issues

Preanalytical variability: the dark side of the moon in laboratory testing

Giuseppe Lippi
  • Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Gian Cesare Guidi
  • Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Camilla Mattiuzzi / Mario Plebani
Published Online: 2011-09-21 | DOI: https://doi.org/10.1515/CCLM.2006.073

Abstract

Remarkable advances in instrument technology, automation and computer science have greatly simplified many aspects of previously tedious tasks in laboratory diagnostics, creating a greater volume of routine work, and significantly improving the quality of results of laboratory testing. Following the development and successful implementation of high-quality analytical standards, analytical errors are no longer the main factor influencing the reliability and clinical utilization of laboratory diagnostics. Therefore, additional sources of variation in the entire laboratory testing process should become the focus for further and necessary quality improvements. Errors occurring within the extra-analytical phases are still the prevailing source of concern. Accordingly, lack of standardized procedures for sample collection, including patient preparation, specimen acquisition, handling and storage, account for up to 93% of the errors currently encountered within the entire diagnostic process. The profound awareness that complete elimination of laboratory testing errors is unrealistic, especially those relating to extra-analytical phases that are harder to control, highlights the importance of good laboratory practice and compliance with the new accreditation standards, which encompass the adoption of suitable strategies for error prevention, tracking and reduction, including process redesign, the use of extra-analytical specifications and improved communication among caregivers.

Keywords: error; laboratory instrumentation; laboratory testing; preanalytical variability

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About the article

Corresponding author: Prof. Giuseppe Lippi, MD, Istituto di Chimica e Microscopia Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, 37134 Verona, Italy Phone: +39-045-8074516, Fax: +39-045-8201889,


Received: 2005-11-19

Accepted: 2006-01-03

Published Online: 2011-09-21

Published in Print: 2006-04-01


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2006.073.

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©2006 by Walter de Gruyter Berlin New York. Copyright Clearance Center

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[87]
Giuseppe Lippi and Mario Plebani
Clinica Chimica Acta, 2011, Volume 412, Number 3-4, Page 400
[88]
Laura Sciacovelli and Mario Plebani
Clinica Chimica Acta, 2009, Volume 404, Number 1, Page 79
[89]
Gian Cesare Guidi and Giuseppe Lippi
Clinica Chimica Acta, 2008, Volume 393, Number 1, Page 9
[90]
Mario Plebani
Clinica Chimica Acta, 2009, Volume 404, Number 1, Page 59
[91]
Mario Plebani
Clinica Chimica Acta, 2009, Volume 404, Number 1, Page 16
[92]
Mohamed E. Gomah, James P. Turley, Huimin Lu, and Dan Jones
The Journal of Molecular Diagnostics, 2010, Volume 12, Number 1, Page 51
[93]
Hershel Raff and Patrick M. Sluss
Steroids, 2008, Volume 73, Number 13, Page 1297
[94]
Giuseppe Lippi and Gian Cesare Guidi
Artificial Intelligence in Medicine, 2011, Volume 52, Number 3, Page 193
[95]
Azlinda Anwar, Guoqiang Wan, Kaw-Bing Chua, Joseph Thomas August, and Heng-Phon Too
The Journal of Molecular Diagnostics, 2009, Volume 11, Number 6, Page 537
[96]
Giuseppe Lippi, Jeffrey J. Chance, Stephen Church, Paola Dazzi, Rossana Fontana, Davide Giavarina, Kjell Grankvist, Wim Huisman, Timo Kouri, Vladimir Palicka, Mario Plebani, Vincenzo Puro, Gian Luca Salvagno, Sverre Sandberg, Ken Sikaris, Ian Watson, Ana K. Stankovic, and Ana-Maria Simundic
Clinical Chemistry and Laboratory Medicine, 2011, Volume 49, Number 7
[97]
Clinical Chemistry and Laboratory Medicine, 2011, Volume 49, Number s1
[98]
Giuseppe Lippi, Luigi Ippolito, and Rossana Fontana
Clinical Chemistry and Laboratory Medicine, 2011, Volume 49, Number 5
[99]
Judy E. Brown, Nancy Smith, and Beth R. Sherfy
Journal of Nursing Care Quality, 2011, Volume 26, Number 1, Page 13
[100]
Giuseppe Lippi and Mario Plebani
Scandinavian Journal of Clinical and Laboratory Investigation, 2009, Volume 69, Number 8, Page 811
[102]
Mario Plebani
Clinical Chemical Laboratory Medicine, 2007, Volume 45, Number 6
[103]
Alberta Caleffi, Roberto Rosso, and Giuseppe Lippi
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 11
[104]
Ashok Rattan and Giuseppe Lippi
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 11
[106]
Giuseppe Lippi, Mario Plebani, Emmanuel J. Favaloro, and Tommaso Trenti
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 7
[107]
Mario Plebani and Giuseppe Lippi
Clinical Chemistry and Laboratory Medicine, 2009, Volume 47, Number 8
[108]
Binita Goswami, Bhawna Singh, Ranjna Chawla, and Venkatesan Mallika
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 1
[109]
Robert C. Hawkins
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 7
[110]
Robert F. Ritchie, Thomas B. Ledue, and Wendy Y. Craig
Clinical Chemical Laboratory Medicine, 2007, Volume 45, Number 2
[111]
M Jesús Alsina, Virtudes Álvarez, Núria Barba, Sandra Bullich, Mariano Cortés, Irene Escoda, and Cecília Martínez-Brú
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 6
[112]
Giuseppe Lippi, Martina Montagnana, and Davide Giavarina
Clinical Chemistry and Laboratory Medicine (CCLM), 2006, Volume 44, Number 12
[113]
Emmanuel J. Favaloro and Giuseppe Lippi
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 3
[114]
Giuseppe Lippi, Gian Luca Salvagno, Martina Montagnana, Giorgio Brocco, and Gian Cesare Guidi
Clinical Chemistry and Laboratory Medicine (CCLM), 2006, Volume 44, Number 8
[115]
Giuseppe Lippi and Mario Plebani
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 6
[116]
Giuseppe Lippi, Norbert Blanckaert, Pierangelo Bonini, Sol Green, Steve Kitchen, Vladimir Palicka, Anne J. Vassault, Camilla Mattiuzzi, and Mario Plebani
Clinical Chemistry and Laboratory Medicine, 2009, Volume 47, Number 2
[117]
Michel R. Langlois and Pierre Wallemacq
Clinical Chemistry and Laboratory Medicine, 2009, Volume 47, Number 10
[118]
Adolfo Romero, Andrés Cobos, Ana López-León, Germán Ortega, and Manuel Muñoz
Clinical Chemistry and Laboratory Medicine, 2009, Volume 47, Number 12
[119]
Esther A. Jensen, Marta Stahl, Ivan Brandslund, and Per Grinsted
Clinical Chemical Laboratory Medicine, 2008, Volume 46, Number 2
[120]
Mario Plebani
Clinical Chemical Laboratory Medicine, 2007, Volume 45, Number 4
[121]
Giuseppe Lippi and Gian Cesare Guidi
Clinical Chemical Laboratory Medicine, 2007, Volume 45, Number 6
[122]
Neelam Chhillar, Sarbjeet Khurana, Rachna Agarwal, and Neeraj Kumar Singh
Indian Journal of Clinical Biochemistry, 2011, Volume 26, Number 1, Page 46
[123]
L. Gendt and A. Szymanowicz
Bio tribune magazine, 2010, Volume 36, Number 1, Page 50
[124]
Mario Plebani and Elisa Piva
Journal of Medical Biochemistry, 2010, Volume 29, Number 4
[125]
Giuseppe Lippi, Giuseppe Banfi, and Nicola Maffulli
European Journal of Applied Physiology, 2010, Volume 109, Number 5, Page 1003
[126]
G. LIPPI, G. L. SALVAGNO, D. M. ADCOCK, M. GELATI, G. C. GUIDI, and E. J. FAVALORO
International Journal of Laboratory Hematology, 2010, Volume 32, Number 1p2, Page 132
[127]
Giuseppe Lippi, Massimo Franchini, Martina Montagnana, Gian Luca Salvagno, Giovanni Poli, and Gian Cesare Guidi
Blood Coagulation & Fibrinolysis, 2006, Volume 17, Number 7, Page 513
[128]
Giuseppe Lippi, Gian Luca Salvagno, Martina Montagnana, Giovanni Poli, and Gian Cesare Guidi
Blood Coagulation & Fibrinolysis, 2006, Volume 17, Number 7, Page 557
[129]
G. L. SALVAGNO, G. LIPPI, M. MONTAGNANA, M. FRANCHINI, G. POLI, and G. C. GUIDI
International Journal of Laboratory Hematology, 2009, Volume 31, Number 4, Page 462
[130]
Gian L. Salvagno, Giuseppe Lippi, Antonella Bassi, Giovanni Poli, and Gian C. Guidi
Journal of Evaluation in Clinical Practice, 2008, Volume 14, Number 2, Page 351
[131]
Frank Vitzthum, Gérard Siest, David M. Bunk, Tobias Preckel, Christian Wenz, Patric Hoerth, Peter Schulz-Knappe, Harald Tammen, Juergen Adamkiewicz, Giampaolo Merlini, and N. Leigh Anderson
PROTEOMICS – CLINICAL APPLICATIONS, 2007, Volume 1, Number 9, Page 1016

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