Table 3.
Comparison of responses based on whether the NHSP is implemented
| Category | Question | Institutions that implement the NHSP (N=73), N (%) | Institutions that do not implement the NHSP (N=68), N (%) | P |
|---|---|---|---|---|
| Specimen bottle | Patient information included on the bottle | < 0.0001 | ||
| Barcoded | 38 (52.1) | 11 (16.2) | ||
| Handwritten | 35 (47.9) | 57 (83.8) | ||
| Bottle used for routine chemistry tests | 0.87 | |||
| Plain tube | 13 (17.8) | 13 (19.1) | ||
| SST | 59 (80.8) | 55 (80.9) | ||
| Others | 1 (1.4) | 0 (0.0) | ||
| Factors that determine the specimen tube used | 0.0003 | |||
| Referral laboratory supplies the specimen collection tube | 52 (71.2) | 66 (97.1) | ||
| Clinic provides referral laboratory-recommended bottle | 15 (20.5) | 1 (1.5) | ||
| Clinic purchases the bottles as they see fit | 5 (6.8) | 1 (1.5) | ||
| Unknown* | 1 (1.4) | 0 (0.0) | ||
| Centrifugation | A centrifuge is available at the clinic | 0.0006 | ||
| Yes | 61 (83.6) | 39 (57.4) | ||
| No | 12 (16.4) | 29 (42.6) | ||
| When is centrifugation conducted (if the clinic has an on-site centrifuge) | 0.86† | |||
| ~30 minutes after sampling | 23 (37.7) | 14 (35.9) | ||
| Immediately after sampling | 27 (44.3) | 14 (35.9) | ||
| At a designated time (e.g., once a day in the afternoon) | 7 (11.5) | 3 (7.7) | ||
| Rarely use a centrifuge | 2 (3.3) | 6 (15.4) | ||
| On arrival at the referral laboratory | 2 (3.3) | 1 (2.6) | ||
| Others | 0 (0.0) | 1 (2.6) | ||
| Specimen storage/delivery | Specimen storage temperature after centrifugation | 0.40 | ||
| Refrigerator temperature | 48 (84.2) | 29 (90.6) | ||
| Room temperature | 9 (15.8) | 3 (9.4) | ||
| Specimen storage condition after centrifugation | 0.53‡ | |||
| In an SST | 38 (57.6) | 29 (59.2) | ||
| In a plain tube | 12 (18.2) | 12 (24.5) | ||
| Transfer serum into a serum separator | 9 (13.6) | 6 (12.2) | ||
| Transfer serum into a microtube | 7 (10.6) | 2 (4.1) | ||
| Specimen storage temperature without centrifugation | 0.08 | |||
| Refrigerator temperature | 8 (50.0) | 27 (73.0) | ||
| Room temperature | 8 (50.0) | 9 (24.3) | ||
| Freezing temperature§ | 0 (0.0) | 1 (2.7) | ||
| Specimen storage condition without centrifugation | 0.39ll | |||
| Upright in a test tube rack | 14 (87.5) | 27 (73.0) | ||
| Placed upright or tilted in paper cups, etc. | 1 (6.3) | 7 (18.9) | ||
| Storage in a basket, etc. | 1 (6.3) | 2 (5.4) | ||
| Unknown | 0 (0.0) | 1 (2.7) | ||
| Whether a guide on specimen storage has been received from the referral laboratory | 0.14 | |||
| Received | 44 (60.3) | 32 (47.1) | ||
| Not received | 29 (39.7) | 35 (51.5) | ||
| Unknown¶ | 0 (0.0) | 1 (1.5) | ||
| I do not know | 2 (2.7) | 0 (0.0) | ||
| Specimen quality | Frequency of experiencing hemolysis that causes erroneous results | |||
| ~1/10 patients | 1 (1.4) | 3 (4.4) | 0.09** | |
| ~1/100 patients | 11 (15.1) | 15 (22.1) | ||
| ~1/1,000 patients | 36 (49.3) | 17 (25.0) | ||
| ~1/10,000 patients | 16 (21.9) | 25 (36.8) | ||
| Almost never | 9 (12.3) | 8 (11.8) | ||
| If hemolysis is believed to have caused an erroneous result, the following actions are taken | 0.76†† | |||
| Resampling and retesting | 43 (46.2) | 36 (38.7) | ||
| If the test is not critical, no further action is taken | 19 (20.4) | 23 (24.7) | ||
| Inform the patient that no resampling will be conducted | 17 (18.3) | 9 (9.7) | ||
| Retest using the previous specimen | 12 (12.9) | 8 (8.6) | ||
| Do not disclose to the patient; no resampling done | 2 (2.2) | 2 (2.2) | ||
| Others | 0 (0.0) | 4 (4.3) |
*Excluded from analysis; †Centrifugation after clotting vs. others; ‡In plain tubes vs. others; §Excluded from analysis; llPlace tube in an upright position in a test tube rack vs. others (“unknown” excluded); ¶No response to question. Excluded from analysis; **More than 1/1,000 patients vs.<1/10,000 patients; ††Resample and retest vs. others.
Abbreviations: NHSP, National Health Screening Program; SST, serum separating tube.