Presentation and formatting of laboratory results: a narrative review on behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group “postanalytical phase” (WG-POST)

In laboratory medicine, much effort has been put into analytical quality in the past decades, making this medical profession one of the most standardized with the lowest rates of error. However, even the best analytical quality cannot compensate for errors or low quality in the pre or postanalytical phase of the total testing process. Guidelines for data reporting focus solely on defined data elements, which have to be provided alongside the analytical test results. No guidelines on how to format laboratory reports exist. The habit of reporting as much diagnostic data as possible, including supplemental information, may lead to an information overload. Considering the multiple tasks physicians have to do simultaneously, unfiltered data presentation may contribute to patient risk, as important information may be overlooked, or juxtaposition errors may occur. As laboratories should aim to answer clinical questions, rather than providing sole analytical results, optimizing formatting options may help improve the effectiveness and efficiency of medical decision-making. In this narrative review, we focus on the underappreciated topic of laboratory result reporting. We present published literature, focusing on the impact of laboratory result report formatting on medical decisions as well as approaches, potential benefits, and limitations for alternative report formats. We discuss influencing variables such as, for example, the type of patient (e.g. acute versus chronic), the medical specialty of the recipient of the report, the display of reference intervals, the medium or platform on which the laboratory report is presented (printed paper, within electronic health record systems, on handheld devices, etc.), the context in which the report is viewed in, and difficulties in formatting single versus cumulative reports. Evidence on this topic, especially experimental studies, is scarce. When considering the medical impact, it is of utmost importance that laboratories focus not only on the analytical aspects but on the total testing process. The achievement of high analytical quality may be of minor value if essential results get lost in overload or scattering of information by using a non-formatted tabular design. More experimental studies to define guidelines and to standardize effective and efficient reporting are most definitely needed.

在检验医学领域，过去数十年来学界已在分析质量方面投入大量心血，使得该医学专科成为标准化程度最高、差错率最低的专业领域之一。然而，即便最优的分析质量，也无法弥补整个检测全流程中分析前或分析后阶段出现的差错或质量缺陷。当前的数据报告指南仅聚焦于需随分析检验结果一同提交的既定数据要素，尚未有针对实验室报告格式制定的规范。过度堆砌包括补充信息在内的各类诊断数据的报告习惯，可能引发信息过载。考虑到医师需同时处理多项工作，未经筛选的数据呈现方式可能会增加患者风险——关键信息可能被遗漏，或出现并列错误。鉴于实验室的目标应是解答临床疑问，而非仅提供分析结果，优化报告格式或可提升医疗决策的有效性与效率。在这篇叙述性综述中，我们聚焦于长期未受到足够重视的实验室结果报告主题。我们梳理了已发表的相关文献，重点探讨实验室结果报告格式对医疗决策的影响，以及替代报告格式的实现路径、潜在收益与局限性。我们还讨论了诸多影响变量，例如患者类型（如急性与慢性）、报告接收者的医学专科、参考区间的展示方式、实验室报告的呈现媒介或平台（打印纸质版、电子健康档案系统内、手持设备端等）、报告的查看场景，以及单份报告与累积报告在格式设置上的难点。目前该领域的相关证据，尤其是实验性研究，尚且匮乏。在考量医疗影响时，实验室不仅需关注分析环节，更应聚焦整个检测全流程，这一点至关重要。若因采用非格式化的表格化设计导致核心结果在信息过载与分散中丢失，即便实现了高水平的分析质量，其价值也将大打折扣。当前亟需开展更多实验研究，以制定规范并实现高效优质报告的标准化。