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July 8, 1998

Accuracy of Physicians' Office Laboratory Results—Reply

Author Affiliations

Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;280(2):129-132. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-2-jac80010

In Reply.— We concur with Dr Huffstutter that the outcome of a laboratory test depends on the integrity of the total testing process, including preanalytical, analytical, and postanalytical components. Clearly, in many instances the ability to obtain a rapid result is in the patient's best interest. Dr Fischer suggests that our article failed to acknowledge that POLs were successful 96% to 98% of the time. In fact, we presented the data in that format in the first paragraph of our discussion, specifically to acknowledge that "the glass is more than half full." Our discussion begins as it did because we were concerned that some readers might otherwise blindly conclude that a "4 times failure rate" meant that most POLs endangered patients. Although tests may be performed by persons with little training, we believe it is dangerous to conclude that laboratory testing is so simple that patient safety can be ensured by entrusting the process to an individual who lacks sufficient education, training, and experience.

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