Improper Testing Research Articles

Why Name Popularity is a Good Test of Historicity

Abstract Are name statistics in the Gospels and Acts a good test of historicity? Kamil Gregor and Brian Blais, in a recent article of the jshj, argue that the sample of name occurrences in the Gospels and Acts is too small to be determinative and that several statistical anomalies weigh against a positive verdict. Unfortunately, their conclusions result directly from improper testing and questionable data selection. Chi-squared goodness-of-fit testing establishes that name occurrences in the Gospels and Acts fit into their historical context at least as well as those in the works of Josephus. Additionally, they fit better than occurrences derived from ancient fictional sources and occurrences from modern, well-researched historical novels.

Access to struct members and undefined behavior of C code

During software development, novice developers usually receive a lot of error messages and just warnings of various kinds. And if the code simply won't run when there are errors, then the program usually starts when there are various warnings. And here it is important to understand what consequences the presence of warnings of various kinds can lead to. This work aims to study the code's undefined behavior when working with struc-tures in the C programming language when issuing a corresponding compiler warn-ing about returning the address of a local or temporary variable. In the procedural programming language C, there is an ancestor of the OOP class — the structure struct, which encapsulates only the state of the entity. And the question arises — is it possible to work with separate components-fields of such a structure analogously to OOP languages? For research, a simple structure was taken, which contains information about the person's name, surname, and phone number. To access parts of the structure, pseudogetters were used — functions that returned a pointer to the corresponding part of the structure. The research was conducted in the Visual Studio 2019 environment under the control of the Windows 10 operating system when the default C language standard - MSVC and the more modern ISO standard C17 (2018) was selected in the project settings. As a result, a truly undefined behavior of the code was obtained, when the re-sult of the work of the code fragment (function call) depends on many factors: the length of the array, the standard of the C language, the position of a certain part in the structure. An attempt to conduct similar research under the control of the Linux Mint oper-ating system using the gcc compiler version 5.4 was unsuccessful. When compiling the code, a similar warning about returning the address of a local variable was also issued, as in the case of Visual Studio. But when the program was launched, it sim-ply crashed with a message about a segmentation error. Thus, both the Visual Studio 2019 compiler and the gcc compiler warned us about undefined code behavior. But this uncertain behavior was radically different for operating systems and compilers. If after gcc under the Linux OS, the code simply does not work at all and the program stops its work with a segmentation error mes-sage, then after Visual Studio under Windows, inexperienced developers with im-proper testing and verification of the code can miss the code that "does not always work", which can lead to unexpected results, not always pleasant, to say the least. And that's why software developers, especially beginners, should pay attention not only to compilation errors but also to warnings, even if the code works.

Evaluation of Antinuclear Antibody and Subserology Reflex Testing for the Diagnosis of Systemic Autoimmune Rheumatic Disorders in an Academic Teaching Hospital.

The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD). We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing. Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P = .004). Testing patterns were significantly associated with race/ethnicity (P = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites. In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis.

Study of pre-analytical errors in clinical biochemistry laboratory in Dhiraj General hospital, Piparia

Introduction: Pre-analytical errors is the major source of mistakes in laboratory diagnostics. It includes from order of test by physician to sample is ready for analysis. Preanalytical errors are upto 70 % of errors of total diagnostic process. Objectives: 1. To evaluate the pre-analytical errors during pre-analytical testing process; 2. To formulate the possible corrective measures to be taken to minimise such errors. Materials and Methods: A prospective study was done for a period of 2 months from January 2022 to February 2022 in clinical biochemistry laboratory, central laboratory, Dhiraj general hospital, Piparia. All types of preanalytical errors were recorded. Total 15189 specimens were received during this period. Out of which 569 were sorted with pre analytical errors. Results: They were categorised as follows: Improper test request forms (n-91), Improper labelling (n-118), Insufficient sample (n-121), invalid samples (n-127), sample mix ups (n-18), Delay in sample transportation (n-32), Wrong timing for Collection (n-37), sample not received (SNR) (n-17), Sample from IV running area (n-08). Conclusion: The overall percentage of rejection found is 3.75 %. Hemolysis was the most common cause for sample rejection in clinical laboratory.

Laboratory Test Utilization Practices in Hamad Medical Corporation; Role of Laboratory Supervisors and Clinicians in Improper Test Utilization; a Descriptive Pilot Study.

BackgroundThe use of diagnostic laboratory tests is increasing worldwide. Improper test utilization (ITU) is a common problem for all healthcare systems as it costs substantial expenses for the health systems and impacts optimal patient care.PurposeThe present small-scale survey aims to highlight the current practice of ITU among the labs and physicians, and investigate the actions of diagnostic laboratories towards ITU, and identify the reasons affecting test ordering decisions among physicians.MethodsA cross sectional study based on two different surveys was developed and distributed from March 2017 to April 2017 to laboratory supervisors and physicians (clinicians) at Hamad Medical Corporation (HMC), Qatar. Fourteen laboratory supervisors and eighty-nine physicians were surveyed about improper test utilization practices. The overall results are descriptive data.ResultsThe overall proportion of improperly utilized tests detected by the laboratory supervisors were 50.0%, 35.7%, and 14.3% for overused, misused, and underused lab tests, respectively. Among the physicians, 91% used the electronic ordering template to select the appropriate tests. Moreover, 78.7% of the physicians used the clinical guidelines, while 73% were not employing the laboratory handbook. Furthermore, 95.5%% of the physicians preferred to get feedback about inappropriate tests, while 51.1% were not receiving any, and 40.9% were rarely receiving. Finally, 67.4% were unaware of the tests’ costs among surveyed physicians, and 63.6% showed a willingness to reduce their orders if the cost was high and unnecessary.ConclusionThe physician’s and the laboratories’ communication were inadequate and not systematized, causing ITU practices. The improvement strategy should focus on the communication between clinical labs and physicians and enhance physician implementation to order appropriate lab tests. This could be achieved by conducting legitimate educational methodologies, continuous feedback reviews, ongoing audits, executing health information technology instruments, engaging laboratory practice guidelines, and applying demand management and testing algorithms.

Eyewitness memory is reliable, but the criminal justice system is not

ABSTRACT The reliability of any type of forensic evidence (e.g., forensic DNA) is assessed by testing its information value when it is not contaminated and is properly tested. Assessing the reliability of forensic memory evidence should be no exception to that rule. Unfortunately, testing a witness’s memory irretrievably contaminates it. Thus, only the first (properly conducted) test is relevant to the question of whether eyewitness memory is reliable. With few exceptions, the results of studies conducted in the lab and in the real world show that confidence is highly predictive of accuracy on the first test, and high-confidence often implies high accuracy. The fact that many eyewitnesses are known to have made high-confidence misidentifications in the courtroom has cemented the almost universal impression that eyewitness memory is unreliable. However, it is the criminal justice system that is guilty of unwittingly using contaminated memory evidence (relying on the last memory test, in court) in conjunction with an improper testing procedure (namely, a courtroom showup) to win convictions of the innocent. That mistake should no longer be blamed on the unreliability of eyewitness memory.

Inherited predisposition to haematopoietic malignancies: overcoming barriers and exploring opportunities.

Inherited predisposition to haematopoietic malignancies, due to deleterious germline variants in a variety of genes, is an important clinical entity with implications for the health and management of patients and their family members. Unfortunately, there remain several common misconceptions in this field that can result in patients going unrecognised and/or having incomplete or improper testing including: the impression that inherited haematological malignancy syndromes are rare, that myeloid and lymphoid malignancy predisposition syndromes are mutually exclusive, and that solid tumour predisposition syndromes are unique and distinct from haematopoietic malignancy predisposition syndromes. In the present review, we challenge these ideas with our insights into germline genetic testing for these conditions with the hope that increased awareness and knowledge will overcome barriers and lead to improved diagnosis and management.

Evaluation of Pre-analytical Process with Quality Indicators and Six Sigma Methodology in the Parasitology Laboratory of a Tertiary Healthcare Center

Laboratories have important role in decisions related to the patient. Laboratory performance needs to be evaluated to ensure accurate and sustainable laboratory results. Total test process consists of pre-analytical, analytical and post-analytical sub-processes. Most of the laboratory errors occur in pre-analytical process, which is mostly outside the laboratory, and this important situation has to be monitored by laboratory specialists. Although the standard statistical methods in which the frequency is evaluated can reveal which error is more than the others, they cannot determine which error is needed due to the absence of accepted target values. The decision to intervene in errors can only be made according to the targets by evaluating with methods such as six-sigma and quality indicators. Six-sigma method; is a quality management tool that provides information about process performance. Low sigma level indicates variability or errors in the relevant process. Quality indicators have been developed to measure quality and efficiency of laboratory processes. Use of quality indicators is effective in reducing errors, increasing patient safety and helping to meet ISO-15189 requirements. In this study, it was aimed to evaluate pre-analytical process performance in Parasitology Direct Diagnosis Laboratory of Ege University Faculty of Medicine according to the quality targets of International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Laboratory Errors and Patient Safety (IFCC WG-LEPS) and the six-sigma method. The data of rejected samples in our laboratory during the period 2014-2017 were obtained retrospectively from laboratory information system. Errors were classified using laboratory errors classification system. Quality indicators were calculated for each error category and assessed according to IFCC WG-LEPS quality targets. Pre-analytical sigma level was calculated for each year. Our pre-analytical process sigma goal was 4.6. Sigma levels were calculated according to the reasons of rejection and Pareto analysis was performed. All of the rejected samples were pre-analytical process errors. Unacceptable quality indicators according to the IFCC WG-LEPS targets were found as "insufficient sample" in 2015; "insufficient sample" and "inappropriate sample tube" in 2016 and 2017. Our pre-analytical process sigma levels according to the rejection reasons were found to be 4.39, 4.31, 4.11, 4.17, respectively in 2014- 2017. "Improper test request" in 2014, and "insufficient sample" in 2015-2017 had sigma levels below 4.6. In addition "improper test request" in 2014, and "insufficient sample" in 2015, 2016 and 2017 were noticeable in Pareto analysis. In this study, pre-analysis process was evaluated with six sigma method and quality indicators and the areas open for improvement were determined quantitatively. We found "insufficient sample", "improper test request" and "inappropriate sample tube" indicators as inappropriate according to our target values with both quality indicators and six-sigma methods. For this reason, we have planned video conference training focused on error sources for all employees. We consider that risk and number of errors will be reduced and efficiency of whole test process can be increased by evaluating pre-analytical process with accepted methods and monitoring the results. Process evaluation studies with six-sigma and quality indicators are limited in microbiology and parasitology laboratories. We think that laboratory quality is indispensable and this study will be an example for the laboratory specialists who want to evaluate pre-analytical process of their laboratories.

Practical Considerations Regarding Results From Static and Dynamic Load Testing of Bridges

Bridge tests are a helpful tool for bridge assessment and evaluation. Both in the case of a static and dynamic load testing, each element of the test: the load selection and application, the creation of a numerical model to follow the progress of the test or to check the validity of the test results, the measurement process itself and the comparative analysis of experimental results and calculations could be a source of errors in the bridge final evaluation if these errors and uncertainties are not properly considered. The article presents some of the most important factors that may bring errors in the interpretation of the test results and their comparison to targeted values or values derived from a numerical model. This, at the end, may result in the adoption of decisions that are not accurate and appropriate. The selected sources of feasible errors are presented with the division into static and dynamic loading tests. The presented examples of bridge load testing show how the use of improper test methods could lead to significant errors in bridge assessment and evaluation and, consequently, to wrong decisions.

Effects of Antigen Leukocyte Cellular Activation Test-Based Diet on Inflammation, Body Composition, and Medical Symptoms

Abstract Background: Inflammation in the body may be exacerbated by food intolerances, which often go undiagnosed due to delayed symptoms and improper testing. The antigen leukocyte cellular activa...

Health Informatics Tools to Improve Utilization of Laboratory Tests.

Herein, we discuss improper test utilization practices and their implications on delivery of health care, as well as providing a brief explanation of the means to reduce such practices by improvement of personnel factors, particularly involving physicians. The article also elaborates on ways to mitigate improperly utilized test practices using appropriate health informatics technologies to their maximum possible capacities.

PROTOCOL: Collaborative Testing for Improving Student Learning Outcomes and Test‐Taking Performance in Higher Education: A Systematic Review

PROTOCOL: Collaborative Testing for Improving Student Learning Outcomes and Test‐Taking Performance in Higher Education: A Systematic Review

The Case against Improper Purpose as the Touchstone for Invalidity under Section 116 of the Australian Constitution

Section 116 of the Australian Constitution limits the ability of the Commonwealth to legislate in respect of religion. It provides: ‘The Commonwealth shall not make any law for establishing any religion, or for imposing any religious observance, or for prohibiting the free exercise of any religion, and no religious test shall be required as a qualification for any office or public trust under the Commonwealth.’ The limited case law on s 116 holds that the word ‘for’ means ‘for the purpose of’ such that improper legislative purpose is the test for invalidity rather than a consideration of whether an impugned law has the effect of doing one of the things prohibited by s 116. This article argues that the ‘for the purpose of’ interpretation is misconceived and therefore that the improper purpose test is wrong.

Probable glucometer interference caused by topical iodine solution test site preparation

Use of disinfectants, such as alcohol prep pads, for test site preparation have demonstrated alterations in glucose readings. One case report details an overestimation of blood glucose (BG) readings when using Chemstrip bG and Visidex reagent test strips after cleaning test site with povidone-iodine swabs We present a case of a clinically relevant probable drug-device interaction between topical iodine and a point-of-care glucometer in a 28 year old pregnant woman of Chinese descent. In this case, the use of 10% povidone-iodine solution on the testing site before lancing likely resulted in variable and inaccurate BG readings, which was not reproduced when the patient used hand washing instead of iodine. Our report expands on this prior knowledge by demonstrating that such an alteration associated with iodine can occur with modern electrochemical glucometers. In patients that have aberrant or variable BG readings, providers should investigate for improper testing technique.

Goodness of Measurement: Reliability and Validity

The two most important and fundamental characteristics of any measurement procedure are reliability and validity and lie at the heart of competent and effective study. However, these phenomena have often been somewhat misunderstood or under emphasized. How productive can be any research, if the instrument used does not actually measure what it purports to? How justifiable the research that is based on an inconsistent instrument? What constitutes a valid instrument? What are the implications of proper and improper testing? This paper attempts to explore these measurement related concepts as well as some of the issues pertaining thereto.

Evaluating Adherence To Clinical Guidelines For Thrombophilia Screening

Thrombophilia is responsible for a majority of unprovoked vascular thrombotic events, with a positivity rate of approximately 65 percent. Thrombophilia is diagnosed by a combination of genetic, activity-based, antigenic, and serologic tests. These evaluations incur significant costs and frequently require unnecessary consultation with specialists. Many of the tests also require follow-up to exclude transient alterations. In order to improve diagnostic yield, screening guidelines for inherited and acquired thrombophilia have been published by the College of American Pathologists and the International Society of Thrombosis and Haemostasis. This study evaluates diagnostic yield and adherence to clinical guidelines for thrombophilia screening at a major university teaching hospital. MethodsWe performed a retrospective review of laboratory Results for thrombophilia screening tests ordered between August 2010 and June 2013. A thrombophilia workup panel was defined as a group of 2 or more thrombophilia tests, including but not limited to protein C (PC), protein S (PS), and antithrombin (AT) activity. For activity-based and PS free antigen testing, the appropriate confirmatory period was defined as at least 30 days from the initial testing date. For LA and/or serologic evidence of anti-phospholipid antibodies, the appropriate confirmatory period was defined as at least 12 weeks from the initial testing date.Subsequently, approximately 10 percent of the charts were randomly selected for complete chart review. Chart histories were evaluated to assess compliance with the screening guidelines published by the College of American Pathologists and the International Society of Thrombosis and Hemostasis. Patients younger than 18 years of age and charts with inadequate documentation were excluded from full review. ResultsWe identified a total of 2081 patients who had thrombophilia screening, representing 4630 unique thrombophilia panels. First time panel orders had an 18% positivity rate, which was significantly lower than the expected positivity rate if guidelines were followed (p<0.01). Appropriate confirmatory testing of PC, PS, and AT deficiencies was performed in 6.0%, 13%, and 4.6% of cases, respectively. Verification of lupus anticoagulant (LA) and/or serologic anti-phospholipid antibodies (aPLs) was performed in 17% of cases. Overall, only 12% of abnormal Results had appropriate follow-up. When repeated, 40% of AT, 46% of PC, 50% of PS, and 39% of LA remained abnormal.Of the 213 charts reviewed, 113 were excluded due to insufficient documentation. Of the remaining 100 charts, only 27% followed the guidelines for both inherited and acquired thrombophilia screening. Inherited thrombophilia screening was more frequently ordered incorrectly (65%) than acquired thrombophilia screening (44%). Overall, 14% of incorrectly ordered panels were due to medication interactions, 95% due to incorrect indications, and 8% due to both reasons. We further evaluated appropriateness of thrombophilia screening by clinical service. Hematologists and oncologists most frequently followed screening guidelines (61%), followed by internists (40%), transplant surgeons (19%), and obstetrics/gynecologist (15%). Neurologists and nephrologists both had 0% percent adherence to screening guidelines. ConclusionThe majority of thrombophilia screening is ordered in the absence of adequate clinical indications and confirmatory testing is inconsistently performed. This leads to significantly increases in costs associated with improper testing and inadequate diagnosis of thrombophilia due to insufficient follow-up. Our study demonstrates an urgent need for educating health care professionals on the appropriate ordering of thrombophilia screening tests and for implementing laboratory intervention for incorrectly ordered tests. Disclosures:No relevant conflicts of interest to declare.

Commentary on the abuse of metal chelation therapy in patients with autism spectrum disorders.

Approximately half a million patients with autism spectrum disorders are subjected to chelation therapy in the US annually. The overwhelming majority of such cases are chelated for non-accepted medical indications. These patients may seek evaluation when a urine sample is assayed after the administration of a chelating agent and the values obtained have been improperly compared to references ranges for non-chelated urines, causing falsely elevated results. Legitimate practitioners confronted with such data must decide, preferably in consultation with the patient or their guardian(s), whether to do further testing using legitimate methodology or to simply dismiss the results of the improper testing. Bayesian principles tell us that further testing is likely to yield results within normal reference ranges. However, under some circumstances, it is useful to do such testing in order to demonstrate that there is no need for chelation therapy. Unnecessary chelation therapy is expensive, can cause significant acute adverse effects, and may be associated with long-term consequences.

Evaluating Materials and Fuels Using an Atmospheric-Pressure Low-Velocity Burner Rig

In order to meet future Naval performance and safety parameters, it is anticipated that synthetic logistics fuels will be required to meet the current Naval petroleum-based physical, combustion, and chemistry specifications. However, before they are used, these fuels must be certified for use by passing through a series of evaluation tests to ascertain whether their chemical, physical, and combustion properties will have an adverse impact on engines, that herebefore have used specified petroleum,-based fuels. It has been established that low-velocity, atmospheric-pressure burner rigs, when operated properly, simulate the corrosion and degradation of materials operating in the shipboard gas turbines. To evaluate whether new fuels will cause accelerated corrosion in a gas turbine, the corrosion of coated superalloy samples representative of materials in the hot section of gas turbines are exposed to the combustion gaseous products of the new fuels or fuel blends in the burner rig and compared to that of a standard petroleum-based fuel. Parameter control in all tests is critical if proper evaluation and interpretation is to be achieved. Failure to control the parameters leads to uncertainities that will require more testing or deliver unsupportable, indeterminate conclusions. The paper will discuss cases where proper test parameters lead to determining supportable, repeatable conclusions and corrective actions and where improper test procedures and parameter control may lead to unintended, unsupportable conclusions.

Acute Clinical Evaluation of a Left Ventricular Automatic Threshold Determination Algorithm Based on Evoked Response Sensing

Automatic pacing threshold (AT) testing may simplify device follow-up and improve device longevity. This study's objective was to evaluate the performance of a left ventricular (LV) evoked response sensing-based AT algorithm, for cardiac resynchronization therapy (CRT) devices. Patients scheduled for CRT-D/P implant were enrolled. A manual step-down threshold test and a Left Ventricular Automatic Threshold (LVAT) test in each of four pacing vectors-LVTip→Can, LVTip→right ventricle (RV), = LVRing→Can, and LVRing→RV-were conducted. Patients were randomized to either 0.4-ms or 1.0-ms pacing pulse width and in the manual and LVAT test order. A blinded core lab electrophysiologist (EP) determined the threshold using the surface electrocardiogram (gold standard). Data from 70 patients were analyzed. Bipolar LV leads from three major manufacturers were used. A total of 273 AT tests were performed; 12 AT tests did not result in a threshold due to improper testing conditions. Of 261 eligible tests, 234 AT tests (89.6%) returned a threshold measurement. Of the 234 tests, in 233 tests (99.5%) the algorithm-determined threshold matched the EP-determined threshold for that test. A total of 16,689 capture and 526 noncapture beats were collected and the accuracy for detecting capture and noncapture were 98.5% and 99.7% with a two-sided 95% confidence level of (98.4%, 98.7%) and (99.4%, 100%), respectively. No AT threshold measurement was lower than the EP-determined threshold. In this study, the results suggest that the LVAT algorithm is accurate at determining pacing thresholds in multiple pacing configurations and a wide range of LV leads in CRT-D/P patients.

Challenges in Procurement of HIC Resistant Steel Pipes

Welded pipes ordered for wet sour service are required to be manufactured from hydrogen-induced cracking (HIC) resistant steel plates. Pipe manufacturers procure steel plates with HIC testing, and other additional requirements with respect to chemistry, mechanical testing, and non-destructive testing (NDT) to meet client requirements. There have been several worldwide instances when the pipes ordered for wet sour service have failed HIC test at the pipe mill resulting in significant project delays. The causes of HIC test failures range from deliberate mistakes to improper testing practices. Also, subtle changes in steel making and rolling practices contributed to the HIC test failure following the pipe fabrication. Saudi Aramco has established several lines of defense to prevent recurrence of similar failures. Saudi Aramco reservation on mandatory HIC test requirement on seamless pipes as per the latest API 5L 44th edition, is discussed.