Technical Standards and Guidelines for Use of Clinical Genomic Microarray Analysis in Hematopoietic and Other Neoplastic Disorders: A Draft From a Working Group of the American College of Medical Genetics Laboratory Quality Assurance Committee

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4906-4906
Author(s):  
Marilyn L Slovak ◽  
Daynna J Wolff ◽  
Marilyn M Li ◽  
Matthew S Lebo ◽  
Linda D Cooley

Abstract Abstract 4906 Interrogation of the genome utilizing microarray technologies (copy number array-CGH with or without single-nucleotide polymorphism (SNP) probes) allows detection of genomic gains and losses with unprecedented resolution. Array findings are increasing our knowledge of the genetic basis of hematologic and other malignancies. However, prior to the clinical use of these new analytic tools, laboratories must extensively validate multiple parameters such as their platform(s), software, methods, detection limits, and quality control metrics. The laboratory must demonstrate expertise in the performance of the test and interpretation of the results by testing numerous samples, different sample types, and samples from patients with different types of diseases; these array results should then be compared with the results obtained using the gold standard methods. A working group of the Laboratory Quality Assurance committee of the American College of Medical Genetics (ACMG), a professional organization of board-certified clinical and laboratory geneticists, has drafted technical standards and guidelines for clinical laboratories that intend to offer clinical testing using these technologies. The ACMG Technical Standards and Guidelines provide support for clinical laboratory geneticists to help them provide quality laboratory genetic services. The guidelines discuss array design, selection and coverage of the genomic microarray platforms, manufacturer's premarket analytical validation recommendations (assay performance characteristics, quality parameters, and software specifications), laboratory validation recommendations for each neoplastic disorder and tissue type (blood, bone marrow, and formalin-fixed paraffin-embedded tissue), quality control metrics and documentation, and methods for confirmation of the copy number aberrations (e.g., conventional cytogenetics, FISH, PCR, MLPA, or a different microarray). Data analysis, interpretation and reporting recommendations relating to clonal diversity, limitations of the assay, and the assessment of the clinical significance of array findings are included. Quality assurance guidelines address laboratory personnel training and certification, proficiency testing, and clinically appropriate turnaround times. Clinical laboratory medical professionals with appropriate training and certification will correlate clinical and pathological information with array findings for final reporting. The ACMG Laboratory QA committee welcomes input as the draft guidelines are being formulated. Disclosures: No relevant conflicts of interest to declare.

1997 ◽  
Vol 12 (S2) ◽  
pp. 79s-87s ◽  
Author(s):  
W Gaebel

SummaryQuality assurance is the corrective action applied to any observed discrepancy between optimal and actual level of medical care requiring continuous quality control. Obviously, quality assurance is of utmost importance also in psychiatric practice. Quality care as defined by the degree of adherence to standards and guidelines can be measured in terms of structural, process and outcome indicators applied to inpatient, outpatient and complementary services. To promote the implementation of practice guidelines into psychiatric care conceptual, methodological, and organisational requirements must be taken into account.


2019 ◽  
Vol 32 (1) ◽  
pp. 84-86
Author(s):  
Sidra Asad Ali ◽  
Muhammad Shariq Shaikh

Purpose With recent advances in laboratory hematology automation, emphasis is now on quality assurance processes as they are indispensable for generating reliable and accurate test results. It is therefore imperative to acquire efficient measures for recognizing laboratory malfunctions and errors to improve patient safety. The paper aims to discuss these issues. Design/methodology/approach Moving algorithm is a quality control process that monitors analyzer performance from historical records through a continuous process, which does not require additional expenditure, and can serve as an additional support to the laboratory quality control program. Findings The authors describe an important quality assurance tool, which can be easily applied in any laboratory setting, especially in cost-constrained areas where running commercial controls throughout every shift may not be a feasible option. Originality/value The authors focus on clinical laboratory quality control measures for providing reliable test results. The moving average appears to be a reasonable and applicable choice for vigilantly monitoring each result.


2019 ◽  
Vol 21 (10) ◽  
pp. 2405-2405 ◽  
Author(s):  
James T. Mascarello ◽  
◽  
Betsy Hirsch ◽  
Hutton M. Kearney ◽  
Rhett P. Ketterling ◽  
...  

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 768
Author(s):  
Michael J. Kavanaugh ◽  
Steven E. Azzam ◽  
David M. Rockabrand

Malaria rapid diagnostic tests (RDTs) have had an enormous global impact which contributed to the World Health Organization paradigm shift from empiric treatment to obtaining a parasitological diagnosis prior to treatment. Microscopy, the classic standard, requires significant expertise, equipment, electricity, and reagents. Alternatively, RDT’s lower complexity allows utilization in austere environments while achieving similar sensitivities and specificities. Worldwide, there are over 200 different RDT brands that utilize three antigens: Plasmodium histidine-rich protein 2 (PfHRP-2), Plasmodium lactate dehydrogenase (pLDH), and Plasmodium aldolase (pALDO). pfHRP-2 is produced exclusively by Plasmodium falciparum and is very Pf sensitive, but an alternative antigen or antigen combination is required for regions like Asia with significant Plasmodium vivax prevalence. RDT sensitivity also decreases with low parasitemia (<100 parasites/uL), genetic variability, and prozone effect. Thus, proper RDT selection and understanding of test limitations are essential. The Center for Disease Control recommends confirming RDT results by microscopy, but this is challenging, due to the utilization of clinical laboratory standards, like the College of American Pathologists (CAP) and the Clinical Lab Improvement Act (CLIA), and limited recourses. Our focus is to provide quality assurance and quality control strategies for resource-constrained environments and provide education on RDT limitations.


2011 ◽  
Vol 13 (7) ◽  
pp. 680-685 ◽  
Author(s):  
Hutton M Kearney ◽  
Erik C Thorland ◽  
Kerry K Brown ◽  
Fabiola Quintero-Rivera ◽  
Sarah T South

2011 ◽  
Vol 13 (7) ◽  
pp. 667-675 ◽  
Author(s):  
James T Mascarello ◽  
Betsy Hirsch ◽  
Hutton M Kearney ◽  
Rhett P Ketterling ◽  
Susan B Olson ◽  
...  

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