Critical Value of the Clinical Laboratory Test in Thailand
Kulnaree Sirisali MSc*, Sudarat Manochiopinij PhD*, Pairoj Leelahakul MD, PhD*, Varaporn Ruengrai BSc*, Apsorn Sattayakom BSc*, Sophon Sirisali MSc**.
Affiliation : * Department of Clinical Chemistry, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand. ** Department of Microbiology, Phramongkutklao College of Medicine, Bangkok, Thailand
Background : The critical values are the values of laboratory testing results which required attention or action by the
physicians. It is an essential component of good laboratory practice and widely used throughout the world. The present study
examined the current situation on implementing of critical value list (CVL) of Thai clinical laboratory and what factors were
involved in their consideration.
Material and Method: A questionnaire composed of 3 main categories made up of 34 questions was mailed to 450 Thai
clinical laboratories. These participated laboratories were randomly selected from both private-and government-hospitals.
Participated ones were requested to answer the questionnaire and return via mail within two months. Data were analyzed by
Chi-square test on Microsoft Excel.
Results : The results showed that there were only 48.9% of Thai laboratories implemented the CVL. It was found that there
were many factors which governed the implementation of critical values. These factors were significantly different between
those who implement the critical values and those did not (p < 0.01). In regard to private- and government-hospital
laboratories, implementation of CVL was not significant difference (p > 0.1). However, it was found that assigned persons
who responded to notify and act on the critical value was significantly different (p < 0.01). Moreover, there were no significant
differences on laboratory policy, communication method as well as standard operating procedures on critical values between
the private- and government-hospital laboratories (p > 0.1). There were only 20.2% of those who implemented the CVL and
considered this action as a non-troublesome matter. But, a large group of 95.7% considered this matter as an extra-ordinary
tool for quality control of result reporting system.
Conclusion : Thai laboratories perceived the implementation of critical values list differently. There were some factors
beyond their consideration. However, utilizing of CVL would be an extra-ordinary tool for assuring test results.
Keywords : Clinical laboratory, Critical value, Current situation, Implementation
