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Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics
BACKGROUND: The model of end-stage liver disease (MELD) score was established for the allocation of liver transplants. The score is based on the medical laboratory parameters: bilirubin, creatinine and the international normalized ratio (INR). A verification algorithm for the laboratory MELD diagnos...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389365/ https://www.ncbi.nlm.nih.gov/pubmed/34437537 http://dx.doi.org/10.1371/journal.pone.0254219 |
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author | Hunold, Pascal Berg, Thomas Seehofer, Daniel Sucher, Robert Herber, Adam Isermann, Berend Thiery, Joachim Kaiser, Thorsten |
author_facet | Hunold, Pascal Berg, Thomas Seehofer, Daniel Sucher, Robert Herber, Adam Isermann, Berend Thiery, Joachim Kaiser, Thorsten |
author_sort | Hunold, Pascal |
collection | PubMed |
description | BACKGROUND: The model of end-stage liver disease (MELD) score was established for the allocation of liver transplants. The score is based on the medical laboratory parameters: bilirubin, creatinine and the international normalized ratio (INR). A verification algorithm for the laboratory MELD diagnostic was established, and the results from the first six years were analyzed. METHODS: We systematically investigated the validity of 7,270 MELD scores during a six-year period. The MELD score was electronically requested by the clinical physician using the laboratory system and calculated and specifically validated by the laboratory physician in the context of previous and additional diagnostics. RESULTS: In 2.7% (193 of 7,270) of the cases, MELD diagnostics did not fulfill the specified quality criteria. After consultation with the sender, 2.0% (145) of the MELD scores remained invalid for different reasons and could not be reported to the transplant organization. No cases of deliberate misreporting were identified. In 34 cases the dialysis status had to be corrected and there were 24 cases of oral anticoagulation with impact on MELD diagnostics. CONCLUSION: Our verification algorithm for MELD diagnostics effectively prevented invalid MELD results and could be adopted by transplant centers to prevent diagnostic errors with possible adverse effects on organ allocation. |
format | Online Article Text |
id | pubmed-8389365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-83893652021-08-27 Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics Hunold, Pascal Berg, Thomas Seehofer, Daniel Sucher, Robert Herber, Adam Isermann, Berend Thiery, Joachim Kaiser, Thorsten PLoS One Research Article BACKGROUND: The model of end-stage liver disease (MELD) score was established for the allocation of liver transplants. The score is based on the medical laboratory parameters: bilirubin, creatinine and the international normalized ratio (INR). A verification algorithm for the laboratory MELD diagnostic was established, and the results from the first six years were analyzed. METHODS: We systematically investigated the validity of 7,270 MELD scores during a six-year period. The MELD score was electronically requested by the clinical physician using the laboratory system and calculated and specifically validated by the laboratory physician in the context of previous and additional diagnostics. RESULTS: In 2.7% (193 of 7,270) of the cases, MELD diagnostics did not fulfill the specified quality criteria. After consultation with the sender, 2.0% (145) of the MELD scores remained invalid for different reasons and could not be reported to the transplant organization. No cases of deliberate misreporting were identified. In 34 cases the dialysis status had to be corrected and there were 24 cases of oral anticoagulation with impact on MELD diagnostics. CONCLUSION: Our verification algorithm for MELD diagnostics effectively prevented invalid MELD results and could be adopted by transplant centers to prevent diagnostic errors with possible adverse effects on organ allocation. Public Library of Science 2021-08-26 /pmc/articles/PMC8389365/ /pubmed/34437537 http://dx.doi.org/10.1371/journal.pone.0254219 Text en © 2021 Hunold et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hunold, Pascal Berg, Thomas Seehofer, Daniel Sucher, Robert Herber, Adam Isermann, Berend Thiery, Joachim Kaiser, Thorsten Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title | Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title_full | Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title_fullStr | Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title_full_unstemmed | Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title_short | Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics |
title_sort | experiences from six years of quality assured model of end stage liver disease (meld) diagnostics |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389365/ https://www.ncbi.nlm.nih.gov/pubmed/34437537 http://dx.doi.org/10.1371/journal.pone.0254219 |
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