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Hunold, P; Berg, T; Seehofer, D; Sucher, R; Herber, A; Isermann, B; Thiery, J; Kaiser, T.
Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
PLoS One. 2021; 16(8):e0254219 Doi: 10.1371/journal.pone.0254219 [OPEN ACCESS]
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Sucher Robert
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Abstract:
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.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent - administration & dosage
Adult - administration & dosage
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Algorithms - administration & dosage
Child - administration & dosage
Child, Preschool - administration & dosage
Diagnosis, Computer-Assisted - administration & dosage
End Stage Liver Disease - diagnosis, surgery
Female - administration & dosage
Humans - administration & dosage
Infant - administration & dosage
Liver Transplantation - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Models, Biological - administration & dosage
Quality Assurance, Health Care - administration & dosage

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