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Measurement uncertainty in results with no numbers: an overview

In this sixth article in his series, Stephen MacDonald looks at the widespread use of semi-quantitative assays where more research and discussion is needed into how to apply statistical approaches to their measurements, and the impact that has on clinical decision-making.

Most attention, not least in this series of articles, has been focused on quantifying measurement uncertainty in quantitative analysis. The same level of focus has not been extended to qualitative results. 

International guidelines often concentrate on quantitative results, avoiding the challenges of qualitative results. However, the assessment of measurement uncertainty in qualitative results is equally important. It defines incomplete knowledge within the test result. This highlights the need for further research, standardisation, and integration of measurement uncertainty assessment in qualitative analysis guidelines and practices.

Although results expressed on a ratio scale represent most results in laboratory medicine, qualitative results expressed on nominal and ordinal scales are also common. Results in cellular pathology, transfusion, immunology and microbiology are commonly qualitative. While there is a rapid development of quantitative measurement methods that replace qualitative methods in these disciplines, there is also a strong development of more qualitative methods that are highly useful for self-diagnosis and monitoring.

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