Variation in Proficiency Testing Performance by Testing Site
CONTEXT.— Congress enacted the Clinical Laboratory Improvement Amendments of 1988 (CLIA) to promote uniform quality and standards among all testing sites in the United States. The performance indicators specified in the legislation are proficiency testing (PT) performance and periodic inspections. O...
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| Veröffentlicht in: | JAMA : the journal of the American Medical Association 1998-02, Vol.279 (6), p.463-467 |
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| container_title | JAMA : the journal of the American Medical Association |
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| creator | Stull, Tina M Hearn, Thomas L Hancock, John S Handsfield, James H Collins, Carlyn L |
| description | CONTEXT.— Congress enacted the Clinical Laboratory Improvement Amendments of 1988
(CLIA) to promote uniform quality and standards among all testing sites in
the United States. The performance indicators specified in the legislation
are proficiency testing (PT) performance and periodic inspections. OBJECTIVE.— To evaluate variation in PT performance by type of testing facility
during the first year of compulsory participation under CLIA. DESIGN.— All 1994 PT score data electronically reported to the Health Care Financing
Administration as a component of compliance with the CLIA regulations were
obtained. Over 1.2 million PT event scores from 17058 unique testing sites
were sorted into 2 groups based on the type of testing facility: hospitals
and independent laboratories (HI) and all other testing sites (AOT). MAIN OUTCOME MEASURES.— Satisfactory and unsatisfactory performance rates for HI and AOT for
each analyte and/or test, according to the criteria specified by the CLIA
regulations. RESULTS.— The aggregate rates of satisfactory event performance for all regulated
analytes, tests, and specialties were 97% and 91% for the HI and AOT groups,
respectively. The aggregate odds ratio for unsatisfactory PT event performance
for the AOT group compared with the HI group was 2.89, with a range of 2.19
to 7.51 for the individual analytes. CONCLUSION.— There was a consistent difference in PT performance during the first
full year of compulsory PT under the CLIA regulations based on the type of
testing facility performing the analysis. Traditional testing sites achieved
higher rates of satisfactory performance than newly regulated, alternative
testing sites. |
| doi_str_mv | 10.1001/jama.279.6.463 |
| format | Article |
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(CLIA) to promote uniform quality and standards among all testing sites in
the United States. The performance indicators specified in the legislation
are proficiency testing (PT) performance and periodic inspections. OBJECTIVE.— To evaluate variation in PT performance by type of testing facility
during the first year of compulsory participation under CLIA. DESIGN.— All 1994 PT score data electronically reported to the Health Care Financing
Administration as a component of compliance with the CLIA regulations were
obtained. Over 1.2 million PT event scores from 17058 unique testing sites
were sorted into 2 groups based on the type of testing facility: hospitals
and independent laboratories (HI) and all other testing sites (AOT). MAIN OUTCOME MEASURES.— Satisfactory and unsatisfactory performance rates for HI and AOT for
each analyte and/or test, according to the criteria specified by the CLIA
regulations. RESULTS.— The aggregate rates of satisfactory event performance for all regulated
analytes, tests, and specialties were 97% and 91% for the HI and AOT groups,
respectively. The aggregate odds ratio for unsatisfactory PT event performance
for the AOT group compared with the HI group was 2.89, with a range of 2.19
to 7.51 for the individual analytes. CONCLUSION.— There was a consistent difference in PT performance during the first
full year of compulsory PT under the CLIA regulations based on the type of
testing facility performing the analysis. Traditional testing sites achieved
higher rates of satisfactory performance than newly regulated, alternative
testing sites.</description><identifier>ISSN: 0098-7484</identifier><identifier>EISSN: 1538-3598</identifier><identifier>DOI: 10.1001/jama.279.6.463</identifier><identifier>PMID: 9466641</identifier><identifier>CODEN: JAMAAP</identifier><language>eng</language><publisher>Chicago, IL: American Medical Association</publisher><subject>Biological and medical sciences ; Centers for Medicare and Medicaid Services (U.S.) ; Clinical Laboratory Techniques - standards ; Facility Regulation and Control - legislation & jurisprudence ; Humans ; Laboratories ; Laboratories - legislation & jurisprudence ; Laboratories - standards ; Laboratories, Hospital - legislation & jurisprudence ; Laboratories, Hospital - standards ; Medical sciences ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality Assurance, Health Care - legislation & jurisprudence ; Quality Control ; Teaching. Deontology. Ethics. Legislation ; Tests ; United States</subject><ispartof>JAMA : the journal of the American Medical Association, 1998-02, Vol.279 (6), p.463-467</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright American Medical Association Feb 11, 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a325t-65dde6ece1f9c08bcd912dd4447ff772bdf2d89bb39d98ee4f2cc08f2d26b6a43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jama/articlepdf/10.1001/jama.279.6.463$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.279.6.463$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,314,780,784,3340,27924,27925,76489,76492</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2149397$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9466641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stull, Tina M</creatorcontrib><creatorcontrib>Hearn, Thomas L</creatorcontrib><creatorcontrib>Hancock, John S</creatorcontrib><creatorcontrib>Handsfield, James H</creatorcontrib><creatorcontrib>Collins, Carlyn L</creatorcontrib><title>Variation in Proficiency Testing Performance by Testing Site</title><title>JAMA : the journal of the American Medical Association</title><addtitle>JAMA</addtitle><description>CONTEXT.— Congress enacted the Clinical Laboratory Improvement Amendments of 1988
(CLIA) to promote uniform quality and standards among all testing sites in
the United States. The performance indicators specified in the legislation
are proficiency testing (PT) performance and periodic inspections. OBJECTIVE.— To evaluate variation in PT performance by type of testing facility
during the first year of compulsory participation under CLIA. DESIGN.— All 1994 PT score data electronically reported to the Health Care Financing
Administration as a component of compliance with the CLIA regulations were
obtained. Over 1.2 million PT event scores from 17058 unique testing sites
were sorted into 2 groups based on the type of testing facility: hospitals
and independent laboratories (HI) and all other testing sites (AOT). MAIN OUTCOME MEASURES.— Satisfactory and unsatisfactory performance rates for HI and AOT for
each analyte and/or test, according to the criteria specified by the CLIA
regulations. RESULTS.— The aggregate rates of satisfactory event performance for all regulated
analytes, tests, and specialties were 97% and 91% for the HI and AOT groups,
respectively. The aggregate odds ratio for unsatisfactory PT event performance
for the AOT group compared with the HI group was 2.89, with a range of 2.19
to 7.51 for the individual analytes. CONCLUSION.— There was a consistent difference in PT performance during the first
full year of compulsory PT under the CLIA regulations based on the type of
testing facility performing the analysis. Traditional testing sites achieved
higher rates of satisfactory performance than newly regulated, alternative
testing sites.</description><subject>Biological and medical sciences</subject><subject>Centers for Medicare and Medicaid Services (U.S.)</subject><subject>Clinical Laboratory Techniques - standards</subject><subject>Facility Regulation and Control - legislation & jurisprudence</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Laboratories - legislation & jurisprudence</subject><subject>Laboratories - standards</subject><subject>Laboratories, Hospital - legislation & jurisprudence</subject><subject>Laboratories, Hospital - standards</subject><subject>Medical sciences</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality Assurance, Health Care - legislation & jurisprudence</subject><subject>Quality Control</subject><subject>Teaching. Deontology. Ethics. 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Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality Assurance, Health Care - legislation & jurisprudence</topic><topic>Quality Control</topic><topic>Teaching. Deontology. Ethics. Legislation</topic><topic>Tests</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stull, Tina M</creatorcontrib><creatorcontrib>Hearn, Thomas L</creatorcontrib><creatorcontrib>Hancock, John S</creatorcontrib><creatorcontrib>Handsfield, James H</creatorcontrib><creatorcontrib>Collins, Carlyn L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>JAMA : the journal of the American Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stull, Tina M</au><au>Hearn, Thomas L</au><au>Hancock, John S</au><au>Handsfield, James H</au><au>Collins, Carlyn L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variation in Proficiency Testing Performance by Testing Site</atitle><jtitle>JAMA : the journal of the American Medical Association</jtitle><addtitle>JAMA</addtitle><date>1998-02-11</date><risdate>1998</risdate><volume>279</volume><issue>6</issue><spage>463</spage><epage>467</epage><pages>463-467</pages><issn>0098-7484</issn><eissn>1538-3598</eissn><coden>JAMAAP</coden><abstract>CONTEXT.— Congress enacted the Clinical Laboratory Improvement Amendments of 1988
(CLIA) to promote uniform quality and standards among all testing sites in
the United States. The performance indicators specified in the legislation
are proficiency testing (PT) performance and periodic inspections. OBJECTIVE.— To evaluate variation in PT performance by type of testing facility
during the first year of compulsory participation under CLIA. DESIGN.— All 1994 PT score data electronically reported to the Health Care Financing
Administration as a component of compliance with the CLIA regulations were
obtained. Over 1.2 million PT event scores from 17058 unique testing sites
were sorted into 2 groups based on the type of testing facility: hospitals
and independent laboratories (HI) and all other testing sites (AOT). MAIN OUTCOME MEASURES.— Satisfactory and unsatisfactory performance rates for HI and AOT for
each analyte and/or test, according to the criteria specified by the CLIA
regulations. RESULTS.— The aggregate rates of satisfactory event performance for all regulated
analytes, tests, and specialties were 97% and 91% for the HI and AOT groups,
respectively. The aggregate odds ratio for unsatisfactory PT event performance
for the AOT group compared with the HI group was 2.89, with a range of 2.19
to 7.51 for the individual analytes. CONCLUSION.— There was a consistent difference in PT performance during the first
full year of compulsory PT under the CLIA regulations based on the type of
testing facility performing the analysis. Traditional testing sites achieved
higher rates of satisfactory performance than newly regulated, alternative
testing sites.</abstract><cop>Chicago, IL</cop><pub>American Medical Association</pub><pmid>9466641</pmid><doi>10.1001/jama.279.6.463</doi><tpages>5</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; American Medical Association Journals |
| subjects | Biological and medical sciences Centers for Medicare and Medicaid Services (U.S.) Clinical Laboratory Techniques - standards Facility Regulation and Control - legislation & jurisprudence Humans Laboratories Laboratories - legislation & jurisprudence Laboratories - standards Laboratories, Hospital - legislation & jurisprudence Laboratories, Hospital - standards Medical sciences Public health. Hygiene Public health. Hygiene-occupational medicine Quality Assurance, Health Care - legislation & jurisprudence Quality Control Teaching. Deontology. Ethics. Legislation Tests United States |
| title | Variation in Proficiency Testing Performance by Testing Site |
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