Editors' Column
Our competition has a longer) way to 90 „
Automation in Clinical Chemistry During the week of August 18-23, 1974, clinical chemists met at the Sahara Hotel in Las Vegas, Nev., for the 26th National Meeting of the American Association of Clinical Chemists (AACC). From the overcrowded meeting rooms, either the meeting or Las Vegas was a great attraction. I'll give odds that the meeting was the greater attraction, since even on Friday morning, the last day of formal sessions, attendance was still extremely good. Perhaps by that time, no one had any money left to do anything else, but I'll bet that the attendees were actually much interested in what, for the most part, was a good technical program. The symposium called "Research Frontiers" included discussions of mass spectrometry (This is a "mass spectrometer. It is all covered up in this nice set of metal plates which shows how unreal life is. The first thing you do when you buy such a mass spectrometer is tear those plates off because all of these devices require lots of attention and you have to have them accessible.") and fluorescence polarization and its many possible applications (". . . why is it that we can apply it to this many systems that fluorescence polarization isn't immediately applicable to the clinical lab? I think that there are two big problems that have to be really solved . . . before it can be useful say, for example, for serum samples. One is the native fluorescence of serum. . . . The other thing about serum samples is the fact that serum albumin binds almost everything. . . , that gums up the measurement. Those two problems I think would stand in the way before it becomes an easily usable tool."). This symposium, as well as the session on "Analytical Systems," left one with the impression that an analytical technique is not useful in clinical chemistry unless it can be used in a way which requires no effort or thought. In a talk on analytical spectroscopy using vidicon tubes, the speaker noted that ". . . this is a projection for the future. I don't think we have anything here
that you'll be using tomorrow or even next year. . . ." And in a discussion of automated elution electrophoresis, it was stated that "our object is to come up with the proverbial black box where you insert your sample and the results thereafter (are) very highly automated and independent of the operator." I realize that uncomplicated tests that give results as quickly as possible are necessary in a clinical laboratory. However, I believe that it is also necessary for someone in the lab to know just exactly what the instrument that is doing the testing and giving the numbers is capable (and not capable) of. Someone should know what is in the "black box," and why it gives the results that it does give. Someone should be able to tell if the results are right or wrong and why. I would not like to have a computer tell me I'm sick because a capacitor inside of an automated "black box" leaks. And with the trend toward having computers directly reading results from instruments and ultimately (planned) putting the results directly into a patient's chart, who knows? I am not advocating that we abandon automation in clinical testing or that all laboratory personnel be required to know the complete insides of each instrument in the lab, but they should at least know that the insides exist. I too laughed when a slide showing, not the circuit diagram, but a simple picture of the insides of a "black box" was shrugged off with a comment to the effect that these things inside are necessary evils which must be tolerated so that a number can appear on the outside of the box, and therefore you don't want to hear about them. But was it really funny? From quite a few of the talks presented at the AACC meeting, I got the idea that in the desire to make clinical testing free of operator error, the possibility of instrument error is being overlooked. A. A.
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ANALYTICAL CHEMISTRY, VOL. 46, NO. 13, NOVEMBER 1974 ·
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