Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.

<h4>Background</h4>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 labo...

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Autores principales:	Pascal Hunold, Thomas Berg, Daniel Seehofer, Robert Sucher, Adam Herber, Berend Isermann, Joachim Thiery, Thorsten Kaiser
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/baf9ed71c9b54be293dc592ecf794e10
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spelling	oai:doaj.org-article:baf9ed71c9b54be293dc592ecf794e102021-12-02T20:14:55ZExperiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.1932-620310.1371/journal.pone.0254219https://doaj.org/article/baf9ed71c9b54be293dc592ecf794e102021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254219https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Pascal HunoldThomas BergDaniel SeehoferRobert SucherAdam HerberBerend IsermannJoachim ThieryThorsten KaiserPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0254219 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Pascal Hunold Thomas Berg Daniel Seehofer Robert Sucher Adam Herber Berend Isermann Joachim Thiery Thorsten Kaiser Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
description	<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Pascal Hunold Thomas Berg Daniel Seehofer Robert Sucher Adam Herber Berend Isermann Joachim Thiery Thorsten Kaiser
author_facet	Pascal Hunold Thomas Berg Daniel Seehofer Robert Sucher Adam Herber Berend Isermann Joachim Thiery Thorsten Kaiser
author_sort	Pascal Hunold
title	Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
title_short	Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
title_full	Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
title_fullStr	Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
title_full_unstemmed	Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.
title_sort	experiences from six years of quality assured model of end stage liver disease (meld) diagnostics.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/baf9ed71c9b54be293dc592ecf794e10
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Experiences from six years of quality assured Model of End Stage Liver Disease (MELD) diagnostics.

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