基于蒙特卡洛法绘制医学实验室质控规则的功效函数图及应用研究  

Power Function Graph of Quality Control Rules in Medical Laboratories Based on Monte Carlo Method and Its Application Research

作　　者：张津铭 王惠民[3] 钟堃[1] 袁帅[1] 陈星彤 何法霖[1,2] ZHANG Jinming;WANG Huimin;ZHONG Kun;YUAN Shuai;CHEN Xingtong;HE Falin(Beijing Hospital/National Center of Gerontology/Institute of Geriatric Medicine,Chinese Academy of Medical Science/National Center for Clinical Laboratories/Beijing Engineering Research Center of Clinical Diagnosis,Beijing 100730,China;Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Clinical Laboratory,Affiliated Hospital of Nantong University,Jiangsu Nantong 226001,China)

机构地区：[1]北京医院、国家老年医学中心、中国医学科学院老年医学研究院、国家卫生健康委临床检验中心、北京市临床检验工程技术研究中心,北京100730 [2]中国医学科学院、北京协和医学院,北京100730 [3]南通大学附属医院检验科,江苏南通226001

出　　处：《现代检验医学杂志》2024年第4期192-196,共5页Journal of Modern Laboratory Medicine

基　　金：北京医院国家自然科学基金预研专项(BJ-2020-138);国家重点研发计划(2021YFC1005304)。

摘　　要：目的探讨如何绘制功效函数图,并绘制常见的几种质控规则对应的功效函数图以帮助医学实验室选择质控规则。方法收集中国临床检验常用质控规则,基于蒙特卡洛法绘制功效函数图,且将模拟结果与已有结果对比进行验证。结果蒙特卡洛法可简便绘制出最复杂的1_(3s)/2_(2s)/R_(4)s/4_(1s)/8_(x)规则的功效函数图,该方法结果准确度较高,但准确度和精密度与模拟次数呈正相关;统计七种常用的质控规则,其中使用比例最高质控规则的为1_(3s)/2_(2s)规则,其次为1_(3s)/2_(2s)/R_(4)规则,绘制出1_(3s)/2_(2s)/R_(4)7/4_(1s)/10_(x)规则功效函数图,并标出西格玛水平线以帮助实验室确定质控规则。结论蒙特卡洛法绘制功效函数图结果准确,医学实验室可利用该方法自行绘制以满足日常质控要求。Objective To discuss how to plot a power function graph and draw power function graphs corresponding to common quality control rules to assist medical laboratories in selecting quality control rules.Methods Commonly used quality control rules in clinical laboratory testing in China were collected,power function graphs based on the Monte Carlo method were plotted,and the simulation results with existing results were compared and tested the reliability of the method.Results The Monte Carlo method could be used to easily plot power function graphs for the most complex quality control rules such as 1_(3s)/2_(2s)/R_(4)s/4_(1s)/8_(x).This method had a high level of accuracy,but the accuracy and precision were positively correlated with the number of simulations.In terms of statistical proportions of seven commonly used quality control rules,the 1_(3s)/2_(2s)rule had the highest usage proportion,followed by the 1_(3s)/2_(2s)/R_(4)s.The power function graph corresponding to the 1_(3s)/2_(2s)/R_(4)s/4_(1s)/10_(x)rule was plotted,and the sigma level lines were marked to assist the laboratory in selecting quality control rules.Conclusion The Monte Carlo method accurately plotted power function graphs,and medical laboratories could use this method to independently plot efficiency function graphs to meet quality control requirements.

关 键 词：质量管理 室内质控 功效函数图 

分 类 号：R446[医药卫生—诊断学]