Based on 12 primary indicators and 39 secondary indicators listed in the WHO’s LAT, China’s practices, literature reviews, and brainstorming, a comprehensive indicator evaluation system, including 12 primary indicators and 37 secondary indicators of management for pathogenic microbiology laboratories, was established herein. These indicators comprised organizational operation and management, documentation, sample collection, processing and transportation, data and information, consumables and reagents, equipment, analysis and testing capabilities, quality control, facilities, human resources, biological risks, and public health functions. Compared with the original LAT, the revised indicator system removed “gap analysis” from primary indicators and included “quality control.” Secondary indicators were adjusted under the framework of the new primary indicators. Although there were differences between the new evaluation system and LAT, the new one better reflects China’s actual practices and meets the standard requirements. It also conforms to the WHO’s concept of formulating LAT that encourages users to modify the LAT as per their own conditions. For example, a Thai study adopted 15 modules with quantitative output .
Management of laboratory biosafety risk has always been an important and difficult aspect of laboratory management. In this evaluation, χ11 (biological risks) had the highest score (95.19), which is largely explained by the continuous training provided by the Chinese disease control system. Training in biological risk management is critical, and should be ongoing conducted at all safety levels laboratories. However, χ7 (analysis and testing capacity) scored the lowest (76.92). Analysis revealed that the laboratories are efficient at detecting viruses and bacteria but are insufficient in parasite detection, which was responsible for overall low scores. With rapid economic development, greatly improved sanitary conditions, and a reduction in the need for parasite detection, laboratories have emphasized the development of bacterial and virus detection to ensure detection ability.
LAT does not give weight to each indicator, but the authors of this study believe that the role and impact of each indicator on laboratory management are different. We conclude that giving different weights to different indicators enables investigators to understand better the status and role of important indicators in the evaluation of the laboratory management process. However, as experts remain divided on the importance of each indicator, the weights assigned to various indicators vary from one expert to another. As such, in this study, both subjective and objective methods are employed for assigning weights to minimize the impact of subjective evaluation. The two types of weighting methods have their own advantages and disadvantages. The subjective weighting method entails experts to reasonably determine the rank of the weight coefficients of various indicators to resolve problems, resulting in a large extent of subjectivity. In contrast, the objective weighting method is based on objective data; however, the determined weights are, at times, contradictory to the actual importance of the indicators.[28, 29] In the present study, the three primary indicators given the highest weights were χ7 (analysis and testing capacity), χ1 (organization operation and management), and χ12 (public health functions), whereas the three with the lowest weights were χ9 (facilities), χ6 (equipment), and χ5 (consumables and reagents). These results indicate that more attention should be paid to “analysis and testing capacity”, “organizational operation and management” and “public health functions” for the daily management of the laboratories.
Provincial CDCs play a crucial role in disease monitoring, prevention, and control, as well as public health decision-making. The level of laboratory management matters when it comes to the evaluation of CDC capacity building. In this study, we compared the differences in laboratory management of the provincial CDCs and identified areas in which the laboratories should strengthen the capacity building. Analyses revealed that laboratory A performed the poorest, with only χ7 (analysis and testing capacity) ranking top. B was number one in χ2 (documents), and χ12 (public health functions) but had low scores in χ4 (data and information) and χ7 (analysis and testing capacity), ranking sixth. C did well in 8 indicator, including χ1 (organizational operation and management), χ2 (documents) and so on, but lagged behind in χ6 (equipment) and χ7 (analysis and testing capacity). D had top scores in χ2 (documents), χ8 (quality control), and χ12 (public health functions), but ranked sixth in χ3 (sample collection, processing, and transportation). E ranked first in χ2 (documents) and χ11 (biological risks), with no indicators that were in the last place. F ranked first in χ6 (equipment) and last in χ2 (documents), χ10 (human resources), χ11 (biological risks), and χ12 (public health functions). G had the highest scores in χ7–χ11, with no last-ranked indicators. Therefore, this study will help CDC focus on the areas that need to be improved in comparison with other CDC and provides a reference for further efforts.