{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:56:28Z","timestamp":1793278588723,"version":"4.5.0"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"9","funder":[{"name":"The Constructing Project of Clinical Key Disciplines Shanghai","award":["shslczdzk03302"],"award-info":[{"award-number":["shslczdzk03302"]}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3602301"],"award-info":[{"award-number":["2022YFC3602301"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Xuhui District Artificial Intelligence Collaboration Project","award":["2021-001"],"award-info":[{"award-number":["2021-001"]}]},{"DOI":"10.13039\/501100010108","name":"Zhongshan Hospital","doi-asserted-by":"publisher","award":["2023ZSQN30"],"award-info":[{"award-number":["2023ZSQN30"]}],"id":[{"id":"10.13039\/501100010108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82102468"],"award-info":[{"award-number":["82102468"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172348"],"award-info":[{"award-number":["82172348"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82402736"],"award-info":[{"award-number":["82402736"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U23A20458"],"award-info":[{"award-number":["U23A20458"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-0163_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Recent advances in information technology have renewed interest in patient-based real-time quality control (PBRTQC) as an alternative to internal quality control (IQC). However, since regulations mandate IQC, PBRTQC can only be implemented as a separate system. The additional labor required for PBRTQC may hinder widespread adoption. Therefore, a more efficient system that integrates IQC with PBRTQC is needed for laboratories to implement the methods effectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0163_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A QC system that integrates IQC with PBRTQC is proposed. The maximum average number of patients with unacceptable analytical errors (MaxANP\n                      <jats:sub>TE<\/jats:sub>\n                      ) was introduced as a critical metric to benchmark the efficiency of the integrated PBRTQC system against the IQC-only system using a modified Parvin patient risk model. With the historical data of serum sodium (Na), chloride (Cl), alanine aminotransferase (ALT), and creatinine (CREA) from Zhongshan Hospital, Fudan University, in 2019, the integrated system incorporating the simple PBRTQC model and the more advanced regression-adjusted real-time quality control (RARTQC) were compared with the IQC-only system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0163_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In most cases, the integrated system incorporating RARTQC models outperformed the IQC-only system, particularly for ALT, where QC events were reduced by up to 45\u202f%. Based on these findings, we proposed strategies for laboratories to design the integrated system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0163_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study demonstrated the improvement of efficiency of the integrated PBRTQC system over the IQC-only system. These insights can help laboratories make informed decisions on adopting PBRTQC models and provide as evidence for revising regulation on\u00a0IQC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-0163","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T19:37:42Z","timestamp":1743709062000},"page":"1716-1727","source":"Crossref","is-referenced-by-count":5,"title":["Improving the efficiency of quality control in clinical laboratory with an integrated PBRTQC system based on patient risk"],"prefix":"10.1515","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7103-189X","authenticated-orcid":false,"given":"Xincen","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-9134","authenticated-orcid":false,"given":"Tony","family":"Badrick","sequence":"additional","affiliation":[{"name":"Royal College of Pathologists of Australasia, Quality Assurance Program , St Leonards, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqi","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1228-0770","authenticated-orcid":false,"given":"Andreas","family":"Bietenbeck","sequence":"additional","affiliation":[{"name":"MVZ Labor Poing , Poing , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhai","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Information Technology , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baishen","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5167-170X","authenticated-orcid":false,"given":"Beili","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Zhongshan Hospital, Fudan University , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"2026051215061112908_j_cclm-2025-0163_ref_001","doi-asserted-by":"crossref","unstructured":"Loh, TP, Cervinski, MA, Katayev, A, Bietenbeck, A, van Rossum, H, Badrick, T, et al.. 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