The role of operational research in clinical chemistry.

This paper begins with a critical examination of the published account (Carruthers, 1970) of a pioneering study of simulation in a clinical chemistry laboratory. It next considers the basic requirements for the formal mathematical description of such a laboratory: these include the setting of criteria, the resource and input variates, and the definition of success by means of criterion variates. Investigation of criterion variates can be by direct measurement, or by a theoretical approach which may include simulation. The aims of simulation are discussed and an attempt to simulate the operation of a large clinical chemistry laboratory is described. The difficulty of constructing an overall measure of efficiency is considered in relation to improving performance within an existing framework, to evaluating new equipment such as computers on-line to laboratory apparatus, and to inter-laboratory comparisons of performance. It is concluded that complex operational research techniques, including simulation, have little to offer at least for the present, and may even lead to misleading conclusions.