Abstract
data. If the quality of the laboratory is poor then the decision may be made to ignore the laboratory result and proceed to care for the clinical condition of the patient. Alternately, the physician may decide to reorder the test a second time to see if a statistically different result is obtained. Most interferences in analytical methodologies can be eliminated by a chromatographic sample preparation step prior to analysis. However, chromatographic separations are not usually automated, are poorly mechanized, and add time and expense to the analysis. In a high volume service clinical chemistry laboratory, the extra step required by a chromatographic separation is very undesirable. Therefore, today many inaccuracies remain with the routine methods used rather than adapt a cure for the accuracy problem by adding a manual chromatographic sample preparation step. In conclusion, the development of highly accurate instrumental methods of chemical analysis for the clinical laboratory remains a very difficult task. When one includes the nonanalytical priorities in method development, then decreasing emphasis on accuracy is often accepted by members of this field. Decentralization of the service laboratory causes some additional reassessment of the criteria for test methods. A list of desired characteristics for test methodology can be created. That list of performance criteria in decreasing order of importance is: 24-hour availability of results, minimum sample pretreatment, wide selection of different types of tests, low operator skill, high precision, low total cost per analysis, short throughput time, and high accuracy. Analytical chemistry has much to contribute to the field of clinical chemistry analysis but ways must be found to produce highly accurate test results while lowering the cost and decreasing the difficulty of the analysis. We as analytical chemists have addressed the cost issue but have not contributed much to the improvement of accuracy while simplifying the technical difficulty of the clinical laboratory tests. This last task then remains as a challenge for the near future.
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