Here’s Wally: finding what you expect to find

Zeh et al. have published an uncommon paper showing that ISO 15189 is wonderful – just as the cartel tells its victims.

Field Experience in Implementing ISO 15189 in Kisumu, Kenya.

American Journal of Clinical Pathology doi: 10.1309/AJCPZIRKDUS5LK2D (2010) American Journal of Clinical Pathology, 134, 410-418.

As for cost saving, how correct is it to include that $60,000 in the top line as a cost of delivering the service pre-accreditation?  The cost arises directly from preparation for accreditation and would not have been incurred without it.  This cost should be shifted to the post-accreditation column where it shows that the cost of the first year after accreditation was approximately double the cost before.  This seems not to be a recurring figure, but the cost after accreditation remains high and the completeness of the figures is plainly incomplete.  No account is taken of the additional staff time spend on administering the inspection system.  The authors acknowledge some of the other costs that were not included in this table.
Figure 3

Figure 3. Trends in the number of complaints from January 2006 (preaccreditation) to January 2009 (postaccreditation). Accreditation occurred in March 2008.

High complaints fell as the lab moved towards accreditation.  No improvement occurred after accreditation because the level is so low.  This indicates the improvement that can be achieved when a poor lab is properly resourced and organised.  To know if it was uniquely due to accreditation cannot be said from this report.  It was not designed to show whether resources, organisation, accreditation, broken telephones, dishonest postmen or some other factors caused the reduction in complaints.

How did this manuscript pass peer-review?  Let’s hope readers don’t accept such papers  at face value.   It is largely descriptive and provides little real evidence that accreditation is solely responsible for the improvements.  
This entry was posted in Cartel, Laboratory medicine, Management, Medicine and tagged , , , , . Bookmark the permalink.

1 Response to Here’s Wally: finding what you expect to find

  1. Bazonka says:

    I know that if anyone shows me a graph they are almost certainly trying to mislead me, it is my job to work out how. Thank you for your guidance.

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