Your doctor is as good as the lab and imaging results

Often, whenever there is a wrong diagnosis, we blame the doctor.

On numerous occasions, I have encountered cases where a doctor has been wrongly accused by a patient. I have also seen cases where a patient comes to hospital when his/her condition has deteriorated and a review of their previous treatment reveals missed opportunities for better health outcomes due to wrong or incomplete diagnosis in the laboratory or imaging results.

“Your doctor is as good as the diagnostic test results” is one of my mottos. Even the best specialist will make an incorrect assessment of a patient’s condition if presented with the wrong diagnostic test results.

A doctor uses the results presented to them to make the correct diagnosis and to develop a treatment plan. Sometimes, a health professional will ask for a repeat of the tests if there are inconsistencies or when the treatment plan presents gaps, but not always. Therefore, accuracy of results is of utmost importance.

Qualified professionals

What makes a good diagnostic centre?

Firstly, the right technology and personnel. Correct diagnosis requires the right equipment to eliminate the risk of errors and improve health outcomes. The use of advanced technologies helps to process tests correctly, efficiently and precisely. We must, therefore, ensure that diagnostic centres have state-of-the art equipment for the tests required.

Even with the right equipment, poorly trained or unqualified personnel will interpret tests wrongly or write wrong reports. Therefore, it is extremely key to have qualified professionals carrying out tests. Also, regular upgrade of knowledge and skills will keep staff up-to-date with the latest developments.

A relevant analogy is air travel. You need modern aeroplanes and qualified pilots to ensure safe air travel. If you do not take a risk when flying, why would you take a risk with your health?

Quality control

Secondly, quality control is key for correct diagnostics. It ensures both precision and accuracy of patient sample results. Regular calibration of laboratory equipment is a critical aspect of quality control. Calibration involves comparing a reading on one piece of equipment or system with another piece of equipment that has been calibrated and referenced to a known set of parameters. The equipment used as a reference should itself be directly traceable to the equipment that is calibrated.

There is an ongoing need to perform calibration at every shift and maintain the calibration of the equipment throughout its lifetime for accurate measurements.

Another aspect of quality control is accreditation by an independent third party. Accreditation is a voluntary programme in which trained external peer reviewers evaluate a healthcare organisation's compliance and compare it with pre-established performance standards. Research shows accreditation improves the quality of care.

Laboratory accreditation is a widely accepted process of evaluating quality, performance, reliability and efficiency. Accreditation from one or more international quality control bodies ensures that a diagnostic centre’s processes are benchmarked on internationally accepted standards and processes. The laboratory also benefits from global new knowledge that helps improves healthcare outcomes.

Delay treatment

The list of international accreditation bodies includes the College of American Pathologists (CAP), Joint Commission International (JCI), South African National Accreditation System (SANAS), International Standardisation Organisation (ISO), United Kingdom Accreditation Services, Clinical Pathology Accreditation and National Association of Testing Authorities.

Accreditation is a rigorous exercise and an investment that takes time, resources and sometimes the re-engineering of your processes to ensure compliance with standards. This process is dynamic and the requirements continually change as new knowledge and standards are adopted globally.

At Aga Khan University Hospital, our laboratory is accredited by CAP and SANAS. This requires us to adhere to standards relating to laboratory records, quality control of procedures for the preceding accreditation period, qualifications of laboratory staff, equipment, facilities, safety programmes and their recording and overall laboratory management. We renew this accreditation every two years.

We also calibrate our equipment within the timelines given under the manufacturer’s instructions.

Accurate diagnosis is the first step towards treating a medical condition. An error in diagnosis can lead to administration of wrong medication while an incomplete diagnosis can delay the treatment, which, in some cases, can be fatal. So, take time to consider these factors as you identify a diagnostics centre for your next test. Your life can literally depend on it.

In summary, Aga Khan University has the following accreditations: ISO, SANAS, JCI and CAP. The reason for all of them is because we care for our patients and want them to receive the best care possible. We care from our heart.

Dr Shawn Bolouki is the Aga Khan University Hospital CEO