Mind the Gap: Difference between knowledge and action in the laboratory

Posted by Sten Westgard, MS

In June of this year, Zoe Brooks presented an AACC-sponsored webinar with the title, Laboratory QC: Bridging the Gap Between Theory and Practice. During this webinar, Zoe presented a poll and more than 100 participants responded. The results are very interesting...

When asked to agree or disagree with this statement, "Method quality is OK if all the results on a QC chart are within +/- 2 SD of the Mean" only 67% of the respondents said No. (I suppose we should be encouraged with that result? More than a majority of laboratorians have learned the most basic lesson of QC.)

But then Zoe did a clever thing. She presented participants with this graph:

Again, she asked, is this method OK or not or is there not enough information? Now only 29% of the participants answered that there was not enough information to make a decision.

Here's the trick: The two questions are the same. The first is a verbal presentation, while the second is a graphic presentation, of the same situation.

Let's be clear. When presented with the theoretical statement, 67% of the participants recognized that using 2sd limits as accepability critieria was not a good idea. But when presented with an actual example in a graph illustrating that theory, about half of those people did use 2sd limits as acceptability criteria. Let's estimate that roughly a third of the participants knew the correct theory, but acted incorrectly in practice.

The moral: even among experienced laboratorians, there is a lot of room for improvement.

I suspect if the poll had asked what rules were actually being used in the participant laboratories, we would find an even larger number still use 2sd limits as acceptability criteria. Even when you know the theory, and can recognize the practice, the pressures of generating fast results often force the capitulation of principles to production.

Zoe's website is http:www.awesome-numbers.org