Bhupinder Singh <bobdog at sancharnet.in> wrote: 

> Dear Sam,
> What you say is correct.
> In clinical practice it is also possible that the same sample is sent to two
> labs for the same test and the protocol followed by both the labs is same so
> is the est method and the unit of reporting. The sample date and time is the
> same. These two results have to be viewed and stored. Thus there should be a
> method to store and retrieve values where the date and time of sample and
> the test type and method and the UOM is the same needs to be available.
> Eg Blood Sugar reporting unit and test method are the same so is the date
> and time of the sample.
> Bhupinder

this is an inteersting scenario actually, since even if there are two
perfectly legitimate test results (let's say submitted to the EHR a day after
each other) they don't really represent distinct results - they are the same
result (presumably) submitted at same or different times. Wen doing
statistical or other queries we have to be careful - if we draw the values on
a graph for example of bsl over last five days, there might be two values at
the one timepoint (where the timepoints are the times of taking samples, not
doing the test - i.e. the biologically significant point in time). One way to
look at thist situation is to say that all test results where there is just a
single result are just a special case of a statistical testing situation in
which at any point in "body time", a sample might be tested any number of
times (and more than one sample might be made as well) - giving a
constellation of results. Where there are multiple results for the one
biological timepoint, we could consider it as a statistical strengthening of
the confidence in the result. Probably what applications processing the
results should do is consider N results at the same biological timepoint to be
the same as one, whoe value is the mean of the N, and whose confidence is some
higher value than that attributed to single value samples.

- thomas beale

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