Abstract：
OBJECTIVE: To survey the World Wide Web for critical limits/critical values, assess changes in quantitative low/high thresholds since 1990-93, streamline urgent notification practices, and promote global accessibility.
METHODS: We identified Web-posted lists of critical limits/values at university hospitals. We compared 2023 to 1990-93 archived notification thresholds.
RESULTS: We found critical notification lists for 26 university hospitals. Laboratory disciplines ranged widely (1-10). The median number of tests was 62 (range 21-116); several posted policies. The breadth of listings increased. Statistically significant differences in 2023 vs. 1990 critical limits were observed for blood gas (pO2, pCO2), chemistry (glucose, calcium, magnesium), and hematology (hemoglobin, platelets, PTT, WBC) tests, and for newborn glucose, potassium, pO2, and hematocrit. Twenty hospitals listed ionized calcium critical limits, which have not changed. Fourteen listed troponin (6), troponin I (3), hs-TnI (3), or troponin T (2). Qualitative critical values expanded across disciplines, encompassing anatomic/surgical pathology. Bioterrorism agents were listed frequently, as were contagious pathogens, although only three hospitals listed COVID-19. Only one notification list detailed point-of-care tests. Two children\'s hospital lists were Web-accessible.
CONCLUSIONS: Urgent notifications should focus on life-threatening conditions. We recommend that hospital staff evaluate changes over the past three decades for clinical impact. Notification lists expanded, especially qualitative tests, suggesting that automation might improve efficiency. Sharing notification lists and policies on the Web will improve accessibility. If not dependent on the limited scope of secondary sources, artificial intelligence could enhance knowledge of urgent notification and critical care practices in the 21st Century.
METHODS: We identified Web-posted lists of critical limits/values at university hospitals. We compared 2023 to 1990-93 archived notification thresholds.
RESULTS: We found critical notification lists for 26 university hospitals. Laboratory disciplines ranged widely (1-10). The median number of tests was 62 (range 21-116); several posted policies. The breadth of listings increased. Statistically significant differences in 2023 vs. 1990 critical limits were observed for blood gas (pO2, pCO2), chemistry (glucose, calcium, magnesium), and hematology (hemoglobin, platelets, PTT, WBC) tests, and for newborn glucose, potassium, pO2, and hematocrit. Twenty hospitals listed ionized calcium critical limits, which have not changed. Fourteen listed troponin (6), troponin I (3), hs-TnI (3), or troponin T (2). Qualitative critical values expanded across disciplines, encompassing anatomic/surgical pathology. Bioterrorism agents were listed frequently, as were contagious pathogens, although only three hospitals listed COVID-19. Only one notification list detailed point-of-care tests. Two children\'s hospital lists were Web-accessible.
CONCLUSIONS: Urgent notifications should focus on life-threatening conditions. We recommend that hospital staff evaluate changes over the past three decades for clinical impact. Notification lists expanded, especially qualitative tests, suggesting that automation might improve efficiency. Sharing notification lists and policies on the Web will improve accessibility. If not dependent on the limited scope of secondary sources, artificial intelligence could enhance knowledge of urgent notification and critical care practices in the 21st Century.
摘要：
目标：为了调查万维网的关键限值/临界值，评估自1990-93年以来定量低/高阈值的变化，简化紧急通知做法，并促进全球可访问性。
方法：我们确定了大学医院在网上发布的关键限值/值列表。我们将2023年与1990-93年的存档通知阈值进行了比较。
结果：我们发现了26所大学医院的严重通知清单。实验室学科范围广泛（1-10）。测试的中位数为62（范围21-116）；一些发布的政策。上市的广度增加了。2023年的统计显着差异与1990年观察到血气（pO2，pCO2）的临界限值，化学(葡萄糖，钙，镁），和血液学(血红蛋白，血小板,PTT,WBC)测试，对于新生儿的葡萄糖，钾，PO2和血细胞比容.二十家医院列出了离子钙的临界限值，没有改变。14个列出的肌钙蛋白（6），肌钙蛋白I(3),hs-TnI(3),或肌钙蛋白T（2）。定性关键值跨学科扩展，包括解剖/手术病理学。生物恐怖主义剂经常被列出，就像传染性病原体一样，尽管只有三家医院列出了COVID-19。只有一个通知列出了详细的护理点测试。两个儿童的医院名单可以通过网络访问。
结论：紧急通知应关注危及生命的情况。我们建议医院工作人员评估过去三十年的临床影响变化。通知列表已展开，特别是定性测试，这表明自动化可能会提高效率。在Web上共享通知列表和策略将提高可访问性。如果不依赖于次要来源的有限范围，人工智能可以增强21世纪的紧急通知和重症监护实践的知识。
方法：我们确定了大学医院在网上发布的关键限值/值列表。我们将2023年与1990-93年的存档通知阈值进行了比较。
结果：我们发现了26所大学医院的严重通知清单。实验室学科范围广泛（1-10）。测试的中位数为62（范围21-116）；一些发布的政策。上市的广度增加了。2023年的统计显着差异与1990年观察到血气（pO2，pCO2）的临界限值，化学(葡萄糖，钙，镁），和血液学(血红蛋白，血小板,PTT,WBC)测试，对于新生儿的葡萄糖，钾，PO2和血细胞比容.二十家医院列出了离子钙的临界限值，没有改变。14个列出的肌钙蛋白（6），肌钙蛋白I(3),hs-TnI(3),或肌钙蛋白T（2）。定性关键值跨学科扩展，包括解剖/手术病理学。生物恐怖主义剂经常被列出，就像传染性病原体一样，尽管只有三家医院列出了COVID-19。只有一个通知列出了详细的护理点测试。两个儿童的医院名单可以通过网络访问。
结论：紧急通知应关注危及生命的情况。我们建议医院工作人员评估过去三十年的临床影响变化。通知列表已展开，特别是定性测试，这表明自动化可能会提高效率。在Web上共享通知列表和策略将提高可访问性。如果不依赖于次要来源的有限范围，人工智能可以增强21世纪的紧急通知和重症监护实践的知识。
