Update chapter1.qmd

Add Dr. C updates

chapter1.qmd

@@ -12,33 +12,36 @@ hospitals had clinical laboratories by 1923 [@berger1999]. Before 1960,
 almost all testing in the laboratory was performed using manual methods.
 In the mid-1960s, a limited amount of automated analyzers became
 available, allowing for more rapid testing and running multiple tests at
-the same time [@park2017]. Since these early days of automation in the
+the same time [@park2017].
-last fifty years, the clinical laboratory has rapidly expanded
+
-automation techniques. These include pre-packaged ready-to-use reagents,
+Since these early days of automation in the last fifty years, the
-automated dispensing, incubation and measurement, automated sample
+clinical laboratory has rapidly expanded automation techniques. These
-processing (e.g., total laboratory automation systems, one- and
+include pre-packaged ready-to-use reagents, automated dispensing,
-two-dimensional bar codes, radio frequency identification tags),
+incubation and measurement, automated sample processing (e.g., total
-multiplexing tests from a single sample (e.g., microarrays), automated
+laboratory automation systems, one- and two-dimensional bar codes, radio
-data processing (e.g., reference range, alert value comparisons, quality
+frequency identification tags), multiplexing tests from a single sample
-control assessment), automated interpretation (e.g., auto-verification),
+(e.g., microarrays), automated data processing (e.g., reference range,
-image analysis (e.g., automated peripheral blood smear morphology -
+alert value comparisons, quality control assessment), automated
-CellaVision, whole slide scanning in surgical pathology), and mobile or
+interpretation (e.g., auto-verification), image analysis (e.g.,
-static robots to operate analyzers [@park2017]. This rise in automation
+automated peripheral blood smear morphology - CellaVision, whole slide
-in the clinical laboratory has also led to the need for more advanced
+scanning in surgical pathology), and mobile or static robots to operate
-computer systems to go along with the advances in instrument technology.
+analyzers [@park2017]. This rise in automation in the clinical
-Over the past few decades, LISs have evolved from relatively narrow,
+laboratory has also led to the need for more advanced computer systems
-often arcane, or home-grown systems into sophisticated systems that are
+to go along with the advances in instrument technology.
-more user-friendly and support a broader range of functions and
+
-integration with other technologies that laboratories deploy
+Over the past few decades, Laboratory Information Systems (LIS) have
-[@henricks2015]. Modern LISs consist of complex, interrelated computer
+evolved from relatively narrow, often arcane, or home-grown systems into
-programs and infrastructure that support laboratories' vast array of
+sophisticated systems that are more user-friendly and support a broader
-information-processing needs. LISs have functions in all phases of
+range of functions and integration with other technologies that
-patient testing, including specimen and test order intake, specimen
+laboratories deploy [@henricks2015]. Modern LISs consist of complex,
-processing and tracking, support of analysis and interpretation, and
+interrelated computer programs and infrastructure that support
-report creation and distribution. In addition, LISs provide management
+laboratories' vast array of information-processing needs. LISs have
-reports and other data that laboratories need to run their operations
+functions in all phases of patient testing, including specimen and test
-and to support continuous improvement and quality initiatives
+order intake, specimen processing and tracking, support of analysis and
-[@henricks2015].
+interpretation, and report creation and distribution. In addition, LISs
+provide management reports and other data that laboratories need to run
+their operations and to support continuous improvement and quality
+initiatives [@henricks2015].
 
 The clinical laboratory's primary business purpose is to provide testing
 results requested by physicians and other healthcare professionals. In a
@@ -55,21 +58,22 @@ algorithms; this is defined as 'reflective testing' [@srivastava2010].
 Both reflex and reflective testing became possible with the advent of
 laboratory information systems (LIS) that were sufficiently flexible to
 permit modification of existing test requests at various stages of the
-analytical process [@srivastava2010]. This research study will focus
+analytical process [@srivastava2010].
-specifically on reflex testing, those tests added automatically by a set
+
-of rules established in each laboratory. In most current clinical
+This research study will focus specifically on reflex testing, those
-laboratories, reflex testing is performed with a 'hard' cutoff, using a
+tests added automatically by a set of rules established in each
-specifically established range with no means of flexibility
+laboratory. In most current clinical laboratories, reflex testing is
-[@murphy2021]. This study will examine the use of Machine learning to
+performed with a 'hard' cutoff, using a specifically established range
-develop algorithms to allow flexibility for automatic reflex testing in
+with no means of flexibility [@murphy2021]. This study will examine the
-clinical chemistry. The goal is to fill the gap between hard-coded
+use of Machine learning to develop algorithms to allow flexibility for
-reflex testing and fully manual reflective testing using machine
+automatic reflex testing in clinical chemistry. The goal is to fill the
-learning algorithms.
+gap between hard-coded reflex testing and fully manual reflective
+testing using machine learning algorithms.
 
 ## Purpose and Research Statement
 
 Develop and test a machine learning algorithm to establish if said
-algorithm can perform better then current hard coded rules to reduced
+algorithm can perform better than current hard-coded rules to reduce
 unnecessary patient testing.
 
 ## Significance