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Tim's CP Board Review > Lab management, Statistics > Flashcards

Lab management, Statistics Flashcards

1
Q

PPM

A

Must be performed by a provider. May have competency assessments but proficiency testing is not required.

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2
Q

DOT categories

A

A - Pathogens, high biological risk

B - Routine biological specimens, some risk

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3
Q

HIPAA exceptions

A

Can send information to insurance groups and other providers without express consent.

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4
Q

Inspections: JCO, CAP, COLA

A

JCO: q3yr hospital, q2yr labs.
CAP: q2yr, off-year self-inspection. Phase 2 worse than 1.
COLA: q2yr, voluntary. For smaller labs

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5
Q

Medical director requirements

A

Mod/High complex: Doctorate with 1+yr experience, or PhD with boarding.
Waived testing: None required.

Director can delegate roles. May cover max of 5 labs.

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6
Q

Competency testing

A

Annual (or q6mo if new hire)

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7
Q

Material retention

A

Most CP things - 2yrs
Cyto slides - 5yrs
AP materials - 10yrs
Forensics - Forever

Suggested cytogenetics and flow 10+ yrs.

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8
Q

Productivity

A

Tests (or product) per tech (or labor).

Higher with automated testing and SMALLER labs?

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9
Q

Lean

A

Toyota method

Identify and remove wasteful steps.

Use physical maps, spaghetti diagrams.

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10
Q

Three day stay

A

Outpatient lab services occurring up to 3 days prior to admission are billed to the admission

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11
Q

AHRQ

A

Agency that examines effectiveness of new treatments

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12
Q

Analytical sensitivity

Analytical specificity

A

A. sens: Ability to detect analyte at low concentrations

A. spec: Ability to detect analyte with interferants

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13
Q

Calibration verification vs assay calibration

A

Calibration verification: Test known concentrates throughout the RR.
Assay calibration: Adjust instrument output to match known concentrates.

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14
Q

Validating FDA-approved assays

A

Need accuracy, precision, RR. Confirmation of manufacturer RR (20-40 cohort OK)

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15
Q

Frequency of QC checking

A

q24hrs (exception: blood gas q8hr or per run)

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16
Q

CLIA certificates

A

Waiver - Most common. For labs that only do waived tests.

Registration - Allows for complex testing to proceed until inspection

17
Q

FMLA

A

12 weeks
Unpaid, job-secure
no gender/sex difference

18
Q

ISO Standard 15189:2007

A

International standard for medical lab quality and competence.

Voluntary. Has no legal authority.

19
Q

Levey Jennings plot

Bland-altman plot

A

Levey-Jennings: Graphs Mean+/- SD over runs or time.

Bland-Altman: Compares % difference to average values

20
Q

PT testing: Unsuccessful, unsatisfactoryu

A

Unsatisfactory: Failed to attain adequate result on an assay
Unsuccessful: Unsatisfactory result on 2+ consecutive attempts.

21
Q

PT testing: Send-outs

A

NEVER DO IT, just specify that you would normally.

22
Q

Root cause analysis

A 
Factor mapping
Tree diagrams
Ishikawa fishbone
Pareto analysis
Fishbone analysis

Seeks to identify many factors in a blameless fashion. Results in an actionabl solution

23
Q

Six Sigma

A

Aims to minimize product defects. Uses “Black belts” and “green belts”…

MBA rubbish.

24
Q

Sec 1877 of SSA (42 USC 1395)

A

Stark low. No referrals for financial benefit (including to family members, etc).

25
Q

Westgard rules

A 
1(2S) - Warning
1(3S)
2(2S)
4(1S)
R(4S)
10(x)
26
Q

SD containers

A

1SD: 68%
2SD: 95%
3SD: 99%

27
Q

Tests to compare datasets

A

If parametric, use student’s T-test.

If non-parametric, use Mann-Whitney.

28
Q

How is efficiency calculated?

A

TP + TN / All outcomes

29
Q

Reagent lease

A

Pay for reagents and depreciation of instrument. Manufacturer retains ownership of instrument.

30
Q

Semi-variable costs

A

“Step variable”, increases with testing volume but not linearly. eg. Supervisors.

31
Q

Turnover rate

A

departures / total staff in a given time period.

Address these with exit interviews.

32
Q

DRGs

A

Only reimburse HOSPITALS for inpatient services (eg, Medicare part A).

Adjustments exist for geographic location, setting, hospital type, and patient demography?

33
Q

SSTs

A

Separates cells and serum. Not good for drug or immunoassay testing (adsorption)

34
Q

Effect of standing, tourniquets

A

Both: Third-spacing (hemoconcentration)

Tourniquets: Lactic acidosis, maybe hyperkalemia (fist clenching)

35
Q

Optical interferants

A

Bilirubin: 340-500 nm
Heme: 412 nm (“Soret band”)
Lipids: Scatters, doesn’t absorb.

36
Q

Likelihood ratio

A

Sens / 1 - spec

Refers to the odds of a positive result in a disease patient relative to non-diseased.

37
Q

CV%

A

SD / Mean

38
Q

How is post-test probability counted?

A

Multiply the pre-test ODDS RATIO by the LR. Then convert back to probability.

Eg: 25% population diseased, test with 5x LR
25%&raquo_space; 33% pre-test odds ratio.
166% post-test odds ratio
166/266 or 62.4% post-test probability

Tim's CP Board Review (16 decks)

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