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Total error vs. measurement uncertainty: revolution or evolution?
Open accessAbstract
The first strategic EFLM conference "Defining analytical performance goals, 15 years after the Stockholm Conference" was held in the autumn of 2014 in Milan. It maintained the Stockholm 1999 hierarchy of performance goals but rearranged them and established five task and finish groups to work on topics related to analytical performance goals including one on the "total error" theory. Jim Westgard recently wrote a comprehensive overview of performance goals and of the total error theory critical of the results and intentions of the Milan 2014 conference. The "total error" theory originated by Jim Westgard and co-workers has a dominating influence on the theory and practice of clinical chemistry but is not accepted in other fields of metrology. The generally accepted uncertainty theory, however, suffers from complex mathematics and conceived impracticability in clinical chemistry. The pros and cons of the total error theory need to be debated, making way for methods that can incorporate all relevant causes of uncertainty when making medical diagnoses and monitoring treatment effects. This development should preferably proceed not as a revolution but as an evolution.
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Biological, preanalytical, and postanalytical variations are not relevant when monitoring variation in control samples, but these variations are relevant when dealing with patient samples.
“Biological, preanalytical, and postanalytical variations are not relevant when monitoring variation in control samples, but these variations are relevant when dealing with patient samples.46”
From Uncertainty in Measurement and Total Error (2017) · cites this paper as [46]
In “Total error and total allowable error” (p. 3), the paper explicitly says biological variation is irrelevant when monitoring control samples but relevant for patient samples. “Are the differences between TE and MU reconcilable?” (p. 4) identifies preanalytical variation among sources encountered with patient samples that internal quality control excludes. The cited passages do not establish the same control-versus-patient distinction for postanalytical variation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredError methods struggle when representing numerous and complex factors influencing measurement results; they cater to the simplest models of reality, the simple addition of orthogonal variances.
“Error methods therefore struggle when representing numerous and complex factors influencing measurement results.They cater to the simplest models of reality, the simple addition of orthogonal variances.46”
From Uncertainty in Measurement and Total Error (2017) · cites this paper as [46]
In “The error and uncertainty paradigms” (p. 2), the paper says the error paradigm struggles with numerous, complex influences and commonly resorts to the simplest models of reality. It gives a different example of such a model, however, and does not describe it as the simple addition of orthogonal variances. (LLM, conf=0.86)
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Citations
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Metadata
- Authors
- Oosterhuis, W. P., & Theodorsson, E.
- Affiliations
- Zuyderland Medisch Centrum (NL)
- Linköping University (SE)
- Corresponding author
- Oosterhuis, Wytze P.
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2016-01-01
- Volume
- 54
- Issue
- 2
- Pages
- 235-9
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W2336625527
- Cited by
- 57
- References
- 12
- Citations by year
- 2026: 6 · 2025: 1 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 11 · 2017: 4 · 2016: 4
- FWCI
- 4.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Physical Sciences › Physics and Astronomy › Instrumentation › Scientific Measurement and Uncertainty Evaluation
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Keywords
- measurement uncertainty, Westgard rules, clinical chemistry, metrology, diagnostic accuracy, treatment monitoring
- MeSH terms
- Models, Theoretical, Quality Control, Clinical Laboratory Techniques, Uncertainty
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