We appreciate the comments of the reader and agree that the need of the
hour is to also highlight common analytical and non-analytical pitfalls
in other streams of medicine apart from endocrinology – for example,
hematology, biochemistry and immunology – to avoid "Labomas" in those
areas [1]. Such data are unfortunately lacking from India. The authors
are currently working on this area, and should soon be able to come out
with concrete Indian data on the same.
Global laboratory data analysis in the West have
revealed that a large majority of the laboratory errors (75% of the
errors) involved wrong patient labeling, with a large fraction of this
error (24% of the errors) occurred at the site of sample collection and
labeling [2]. Labomas have consistently been reported to be
predominantly due to pre- and post-analytical stages errors, rather than
the analytical errors [3]. A study evaluating data obtained from 1,600
testing procedure in general biochemistry and hematology revealed 0.87%
procedures being associated with errors, with preanalytic and post-
analytic errors contributing to 35.7% and 50% of all errors [4]. The
good news is that studies have consistently reported that less than 10%
of all labomas to actually have an impact on patient diagnosis and
management [3,4]. Increased automation, with better analytical
technology have helped in reducing the occurrence of labomas.
References
1. Society for Promotion of Education in
Endocrinology and Diabetes (SPEED) Group, Chittawar S, Dutta D,
Khandelwal D, Singla R. Neonatal endocrine labomas - pitfalls and
challenges in reporting neonatal hormonal reports. Indian Pediatr.
2017;54:757-62.
2. Layfield JL, Anderson MG. Specimen labelling
errors in surgical pathology: An 18-month experience. American J Clin
Pathol. 2010;134:466-70.
3. Mohammedsaleh ZM, Mohammedsaleh F. A review
article of the reduce errors in medical laboratories. Glob J Health Sci.
2014;7:46-51.
4. Miligy DA. Laboratory errors and patient safety. Int J Health Care
Qual Assur. 2015;28:2-10.