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Research shows that laboratory testing methods may influence the timeliness of disease reporting. In Southern Nevada, two commercial laboratories provide the Southern Nevada Health District with the majority of its disease results. These two laboratories use electronic laboratory reporting (ELR), which is not yet fully automated, and results are sent in batches. Four common reportable diseases were examined, three that are tested with culture (can take up to 72h to produce a result), and one with an immunoassay or Ova & Parasite (O&P) examination (result in 24h). The goal of this study was to examine whether the laboratory testing method had an influence over the timeliness of the report when comparing ELR and traditional reporting (paper, telephone, or fax). The purpose was to determine if the laboratories meet the legally mandated report times (24h plus testing time) set forth by Nevada State law.
METHODS: This retrospective analysis of extant data compares report times of campylobacteriosis, salmonellosis, shigellosis, and giardiasis. A two-way analysis of variance (ANOVA) was conducted to test the interaction effects between disease and timeliness. One-way ANOVAs with Tukey’s post hoc tests were conducted to determine how the diseases differed in timeliness between ELR and traditional reporting, one for ELR and one for traditional reporting. Results were statistically significant at p<0.01 to correct for unequal variance.
RESULTS: A two-way ANOVA revealed a significant interaction between report type and disease type, suggesting that one could influence the other (F = 22.257, p<0.001). Also significant were differences in timeliness between disease types (F = 140.127, p<0.001) and between ELR and traditional reports (F = 60.849, p<0.001). The one-way ANOVA and post hoc tests for traditional reporting showed that multiple diseases differed significantly from each other in average days. The ELR test showed that only giardiasis (Mean = 4.15d, faster than all others) differed in time from the other diseases. Traditional reporting was faster than ELR in all cases.
CONCLUSIONS: The differences between ELR and traditional laboratory reporting show that test type does influence timeliness of reporting. The three diseases tested using culture took longer than the test using an immunoassay or O&P examination. This result also suggests that batching could be affecting timeliness in disease reporting, and it is recommended that the laboratories in Southern Nevada implement a real-time ELR system to increase reporting timeliness.