Calibration of Local Systems with Lyophilized Calibrant Plasmas Improves the Interlaboratory Variability of the INR in the Italian External Quality Assessment Scheme

1999 ◽  
Vol 82 (12) ◽  
pp. 1621-1626 ◽  
Author(s):  
Veena Chantarangkul ◽  
Bruno Cesana ◽  
Pier Mannuccio Mannucci ◽  
Armando Tripodi
Keyword(s):  
Quality Assessment ◽  
Statistical Approach ◽  
External Quality Assessment ◽  
Geometric Mean ◽  
Local System ◽  
Sensitivity Index ◽  
Local Calibration ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Interlaboratory Variability

SummaryCalibration with lyophilized calibrant plasmas certified in terms of PT with International Reference Preparations for thromboplastin has been proposed to minimize the effect of coagulometers on the INR. Aim of this study was to test the ability of local calibration with lyophilized calibrant plasmas, combined with a modified statistical approach, to improve the interlaboratory variability of the INR measured on two test plasmas (one coumarin and one artificially-depleted) by participants in the External Quality Assessment Scheme (EQAS). Sets of lyophilized calibrant and test plasmas were sent to the participants in the EQAS, who were asked to determine PT with their own reagent/ instrument combination (local system). Results were returned as PT together with information on the type of local system, the stated International Sensitivity Index (ISI) and the geometric mean of PTs determined by testing with the local system fresh plasmas from 20 healthy subjects. Ninety-two participants using 9 and 11 brands of reagents and instruments returned results. The CV of the INR determined with the stated ISI for the coumarin (Mean INR = 4.39) and artificially-depleted (Mean INR = 4.23) test plasmas were 11.2% and 10.3% and were reduced on the average by 34% and 54%, respectively, when the INR was calculated with the local ISI.In conclusions, results from this field study involving laboratories and testing systems representative of the real situation in oral anticoagulant monitoring in our country, indicate that local calibration by artificially-depleted plasmas, combined with the proposed statistical approach, is suitable to improve the interlaboratory agreement on the INR.

scholarly journals Local Calibration of International Normalised Ratio Improves between Laboratory Agreement: Results from the UK National External Quality Assessment Scheme

1999 ◽  
Vol 81 (01) ◽  
pp. 60-65 ◽  
Author(s):  
I. Jennings ◽  
T. A. L. Woods ◽  
F.E Preston ◽  
S. Kitchen ◽  
Keyword(s):  
External Quality Assessment ◽  
Local System ◽  
Calibration Graph ◽  
Calibration Model ◽  
Local Calibration ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Measurement Systems ◽  
International Normalised Ratio ◽  
The Uk

SummaryIn the present study we have performed local calibration of International Normalised Ratio (INR) measurement systems in a large series of laboratories. We assigned INRs to five lyophilised plasma calibrants, one prepared from normal plasma and four using plasma from war-farinised patients, using different International Reference Preparations for Thromboplastin. These five calibrants, and two lyophilised test plasmas were analysed by 349 centres using 60 different thromboplastin instrument combinations.Plasma calibrants were assigned INRs using the WHO reference thromboplastin RBT-90 or the European reference thromboplastin CRM 149R. Each participating centre determined PTs of the calibrants with their local system. These PTs were then used to construct a local calibration graph relating PT to INR. The PTs of test plasmas were converted directly into INR using the local calibration model and into INR using the conventional method. The overall medians of conventionally derived INRs of two test plasmas analysed in 349 centres were 2.50 and 3.10, compared to 2.47 and 3.04 after local calibration where RBT-90 was employed to assign INRs to calibrants. Use of CRM 149R to assign INRs to calibrants led to a significant (p <0.0001) increase in INR to 2.7 and 3.36 respectively. When results were grouped according to the thromboplastin employed, agreement between results with different reagents was improved by local calibration. There was a significant reduction (p <0.01) in the spread of results in different centres as indicated by a reduction in coefficient of variation.

Establishing an Accuracy Basis for the Vitamin D External Quality Assessment Scheme (DEQAS)

2017 ◽  
Vol 100 (5) ◽  
pp. 1277-1287 ◽  
Author(s):  
Carolyn Q Burdette ◽  
Johanna E Camara ◽  
Federica Nalin ◽  
Jeanita Pritchett ◽  
Lane C Sander ◽  
...  
Keyword(s):  
Vitamin D ◽  
Quality Assessment ◽  
External Quality Assessment ◽  
Measurement Procedure ◽  
Binding Assays ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Hydroxyvitamin D ◽  
Target Values ◽  
High Concentrations

Abstract Until recently, the Vitamin D External Quality Assessment Scheme (DEQAS) assessed the performance of various assays for the determination of serum total 25-hydroxyvitamin D [25(OH)D] by using a consensus mean based on the all-laboratory trimmed mean (ALTM) of the approximately 1000 participants' results. Since October 2012, the National Institute of Standardsand Technology (NIST), as part of the Vitamin D Standardization Program, has participated in DEQAS by analyzing the quarterly serum sample sets using an isotope dilution LC-tandem MS (ID LC-MS/MS) reference measurement procedure to assign an accuracy-based target value for serum total 25(OH)D. NIST has analyzed90 DEQAS samples (18 exercises × 5 samples/exercise) to assign target values. The NIST-assigned values are compared with the ALTM and the biases assessed for various assays used by the participants, e.g., LC-MS/MS, HPLC, and several ligand-binding assays. The NIST-value assignment process and the resultsof the analyses of the 90 DEQAS samples are summarized. The absolute mean bias between the NIST-assignedvalues and the ALTM was 5.6%, with 10% of the samples having biases &gt;10%. Benefits of the accuracy-based target values are presented, including for sample sets with high concentrations of 25(OH)D2 and 3-epi-25(OH)D3.

Precision and accuracy of commercial assays for vancomycin therapeutic drug monitoring: evaluation based on external quality assessment scheme

2020 ◽  
Author(s):  
Chao-Yang Chen ◽  
Meng-Ya Li ◽  
Ling-Yun Ma ◽  
Xing-Yu Zhai ◽  
Dao-Huang Luo ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Quality Assessment ◽  
Bacterial Infections ◽  
External Quality Assessment ◽  
Detection Methods ◽  
Therapeutic Drug ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Percentage Difference ◽  
Precision And Accuracy

Abstract Background Vancomycin remains a mainstay of the treatment of Gram-positive bacterial infections. It is crucial to accurately determine vancomycin serum concentration for adequate dose adjustment. Objectives To evaluate the precision and accuracy of commercial assay techniques for vancomycin concentration and to assess the comparability of vancomycin detection methods in Chinese laboratories. Methods Human serum samples spiked with known concentrations of vancomycin were provided to laboratories participating in the external quality assessment scheme (EQAS). Assay methods included chemiluminescence, enzyme immunoassay (EIA) and so on. The dispersion of the measurements was analysed and the robust coefficient of variation (rCV), relative percentage difference (RPD) and satisfactory rate for method groups were calculated. Moreover, performance of the Chinese laboratories was assessed. Results A total of 657 results from 75 laboratories were collected, including 84 samples from 10 Chinese laboratories. The median rCV, median RPD and satisfactory rates classified by methods ranged from 1.85% to 15.87%, −14.75% to 13.34% and 94.59% to 100.00%, respectively. Significant differences were seen in precision, between kinetic interaction of microparticles in solution (KIMS) and other methods, and in accuracy, between enzyme-multiplied immunoassay technique (EMIT), fluorescence polarization immunoassay (FPIA) and other techniques. Vancomycin detection in China mainly depended on the chemiluminescence and EMIT methods, which tended to result in lower measurements. Conclusions Although almost all assays in this study achieved an acceptable performance for vancomycin serum concentration monitoring, obvious inconsistencies between methods were still observed. Chinese laboratories were more likely to underestimate vancomycin concentrations. Thus, recognizing inconsistencies between methods and regular participation in vancomycin EQAS are essential.

ORALVEQ: External quality assessment scheme of drugs of abuse in oral fluid

2008 ◽  
Vol 182 (1-3) ◽  
pp. 35-40 ◽  
Author(s):  
M. Ventura ◽  
R. Ventura ◽  
S. Pichini ◽  
S. Leal ◽  
P. Zuccaro ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Oral Fluid ◽  
Drugs Of Abuse ◽  
External Quality Assessment ◽  
External Quality ◽  
External Quality Assessment Scheme
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