scholarly journals Statistical Methods for Monitoring the Relationship between the IFCC Reference Measurement Procedure for Hemoglobin A1c and the Designated Comparison Methods in the United States, Japan, and Sweden

2008 ◽  
Vol 54 (8) ◽  
pp. 1379-1385 ◽  
Author(s):  
Andrea Geistanger ◽  
Sabine Arends ◽  
Christoph Berding ◽  
Tadao Hoshino ◽  
Jan-Olof Jeppsson ◽  
...  
Keyword(s):  
Statistical Methods ◽  
Consensus Statement ◽  
Clinical Chemistry ◽  
International Diabetes Federation ◽  
The United States ◽  
Measurement Procedure ◽  
Reference Measurement ◽  
Reference Measurement Procedure ◽  
Comparison Methods ◽  
The Relationship

Abstract Background: The American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD)/International Diabetes Federation (IDF)/IFCC Consensus Statement on the worldwide standardization of HbA1c states that “… [HbA1c] results are to be reported world-wide in IFCC units … and derived NGSP units … , using the IFCC-NGSP master equation.” Methods: We describe statistical methods to evaluate and monitor the relationships as expressed in master equations (MEs) between the IFCC Reference Measurement procedure (IFCC-RM) and designated comparison methods (DCMs) [US National Glycohemoglobin Standardization Program (NGSP), Japanese Diabetes Society/Japanese Society for Clinical Chemistry (JDS/JSCC), and Mono-S in Sweden]. We applied these statistics, including uncertainty calculations, to 12 studies in which networks of reference laboratories participated, operating the IFCC-RM and DCMs. Results: For NGSP and Mono-S, slope, intercept, and derived percentage HbA1c at the therapeutic target show compliance with the respective MEs in all 12 studies. For JDS/JSCC, a slight deviation is seen in slope and derived percentage HbA1c in 2 of the 12 studies. Using the MEs, the uncertainty in an assigned value increases from 0.42 mmol/mol HbA1c (IFCC-RM) to 0.47 (NGSP), 0.49 (JDS/JSCC), and 0.51 (Mono-S). Conclusions: We describe sound statistical methods for the investigation of relations between networks of reference laboratories. Application of these statistical methods to the relationship between the IFCC-RM and DCMs in the US, Japan, and Sweden shows that they are suitable for the purpose, and the results support the applicability of the ADA/EASD/IDF/IFCC Consensus Statement on HbA1c measurement.

scholarly journals A Review of the Challenge in Measuring Hemoglobin A1c

2009 ◽  
Vol 3 (3) ◽  
pp. 439-445 ◽  
Author(s):  
Cas Weykamp ◽  
W. Garry John ◽  
Andrea Mosca
Keyword(s):  
High Performance ◽  
Hemoglobin A1c ◽  
Consensus Statement ◽  
Clinical Chemistry ◽  
Metrological Traceability ◽  
International Diabetes Federation ◽  
The United States ◽  
Medical Laboratory ◽  
Patient Groups ◽  
The Difference

The attraction of the simple biochemical concept combined with a clinical requirement for a long-term marker of glycolic control in diabetes has made hemoglobin A1c (HbA1c) one of the most important assays undertaken in the medical laboratory. The diversity in the biochemistry of glycation, clinical requirements, and management demands has resulted in a broad range of methods being developed since HbA1c was described in the late 1960s. A range of analytic principles are used for the measurement of HbA1c. The charge difference between hemoglobin A0 and HbA1c has been widely utilized to separate these two fractions, most notably found these days in ion-exchange high-performance liquid chromatography systems; the difference in molecular structure (affinity chromatography and immunochemical methods) are becoming widely available. Different results found in different laboratories using a variety of HbA1c analyses resulted in the need for standardization, most notably in the United States, Japan, and Sweden. Designated comparison methods are now located in these three countries, but as they are arbitrarily chosen and have differences in specificity, results of these methods and the reference values and action limits of the methods differ and only harmonized HbA1c in specific geographic areas. A reference measurement system within the concept of metrological traceability is now globally accepted as the only valid analytic anchor. However, there is still discussion over the units to be reported. The consensus statement of the International Federation of Clinical Chemistry (IFCC), the American Diabetes Association, the International Diabetes Federation, and the European Association for the Study of Diabetes suggests reporting HbA1c in IFCC units (mmol/mol), National Glycohemoglobin Standardization Program units (%), and estimated average glucose (either in mg/dl or mmol/liter). The implementation of this consensus statement raised new questions, to be answered in a concerted action of clinicians, biochemists, external quality assessment organizers, patient groups, and manufacturers.

State of the Art in Trueness and Interlaboratory Harmonization for 10 Analytes in General Clinical Chemistry

2008 ◽  
Vol 132 (5) ◽  
pp. 838-846
Author(s):  
W. Greg Miller ◽  
Gary L. Myers ◽  
Edward R. Ashwood ◽  
Anthony A. Killeen ◽  
Edward Wang ◽  
...  
Keyword(s):  
Uric Acid ◽  
State Of The Art ◽  
Clinical Chemistry ◽  
Peer Groups ◽  
Measurement Procedure ◽  
Reference Systems ◽  
Reference Measurement ◽  
Clinical Laboratories ◽  
Routine Measurement ◽  
Fresh Frozen

Abstract Context.—Harmonization and standardization of results among different clinical laboratories is necessary for clinical practice guidelines to be established. Objective.—To evaluate the state of the art in measuring 10 routine chemistry analytes. Design.—A specimen prepared as off-the-clot pooled sera and 4 conventionally prepared specimens were sent to participants in the College of American Pathologists Chemistry Survey. Analyte concentrations were assigned by reference measurement procedures. Participants.—Approximately 6000 clinical laboratories. Results.—For glucose, iron, potassium, and uric acid, more than 87.5% of peer groups meet the desirable bias goals based on biologic variability criteria. The remaining 6 analytes had less than 52% of peer groups that met the desirable bias criteria. Conclusions.—Routine measurement procedures for some analytes had acceptable traceability to reference systems. Conventionally prepared proficiency testing specimens were not adequately commutable with a fresh frozen specimen to be used to evaluate trueness of methods compared with a reference measurement procedure.

scholarly journals Proposed Serum Cholesterol Reference Measurement Procedure by Gas Chromatography–Isotope Dilution Mass Spectrometry

2011 ◽  
Vol 57 (4) ◽  
pp. 614-622 ◽  
Author(s):  
Selvin H Edwards ◽  
Mary M Kimberly ◽  
Susan D Pyatt ◽  
Shelton L Stribling ◽  
Kara D Dobbin ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Gas Chromatography ◽  
Serum Cholesterol ◽  
Isotope Dilution ◽  
Isotope Dilution Mass Spectrometry ◽  
Measurement Procedure ◽  
Standard Reference Materials ◽  
Reference Measurement ◽  
Reference Measurement Procedure ◽  
The Mean

BACKGROUND Our purpose was to establish a mass spectrometry reference measurement procedure (RMP) for cholesterol to use in the CDC's standardization programs. We explored a gas chromatography–isotope dilution mass spectrometry (GC-IDMS) procedure using a multilevel standard calibration curve to quantify samples with varying cholesterol concentrations. METHODS We calibrated the mass spectrometry instrument by isotope dilution with a pure primary standard reference material and an isotopically enriched cholesterol analog as the internal standard (IS). We diluted the serum samples with Tris-HCl buffer (pH 7.4, 0.05 mol/L, 0.25% Triton X-100) before analysis. We used 17 serum pools, 10 native samples, and 2 standard reference materials (SRMs). We compared the GC-IDMS measurements with the CDC's modified Abell–Levy–Brodie–Kendall (AK) RMP measurements and assessed method accuracy by analyzing 2 SRMs. We evaluated the procedure for lack of interference by analyzing serum spiked with a mixture of 7 sterols. RESULTS The mean percent bias between the AK and the GC-IDMS RMP was 1.6% for all samples examined. The mean percent bias from NIST's RMP was 0.5% for the SRMs. The total %CVs for SRM 1951b levels I and II were 0.61 and 0.73%, respectively. We found that none of the sterols investigated interfered with the cholesterol measurement. CONCLUSIONS The low imprecision, linear response, lack of interferences, and acceptable bias vs the NIST primary RMP qualifies this procedure as an RMP for determining serum cholesterol. The CDC will adopt and implement this GC-IDMS procedure for cholesterol standardization.

Verification of Low-Density Lipoprotein Cholesterol Levels Measured by Anion-Exchange High-Performance Liquid Chromatography in Comparison with Beta Quantification Reference Measurement Procedure

2020 ◽  
Author(s):  
Daisuke Manita ◽  
Hiroshi Yoshida ◽  
Isao Koyama ◽  
Masakazu Nakamura ◽  
Yuji Hirowatari
Keyword(s):  
Anion Exchange ◽  
Clinical Laboratory ◽  
Measurement Procedure ◽  
Calculation Methods ◽  
Serum Samples ◽  
Cvd Risk ◽  
Blood Samples ◽  
Reference Measurement ◽  
Reference Measurement Procedure ◽  
Homogeneous Assays

Abstract Background A new lipoprotein testing method based on anion-exchange HPLC (AEX-HPLC) was recently established. We verified the accuracy of LDL-C levels, a primary therapeutic target for the prevention of cardiovascular disease (CVD), measured by AEX-HPLC comparing with LDL-C levels measured by beta quantification-reference measurement procedure (BQ-RMP), homogenous assays, and calculation methods. Methods We compared LDL-C levels measured by AEX-HPLC (adLDL-Ch: LDL-Ch and IDL-Ch) and BQ-RMP using blood samples from 52 volunteers. AdLDL-Ch levels were also compared with those measurements by homogeneous assays and calculation methods (Friedewald equation, Martin equation, and Sampson equation) using blood samples from 411 participants with dyslipidemia and/or type 2 diabetes. Results The precision and accuracy of adLDL-Ch were verified by BQ-RMP. The mean percentage bias [bias (%)] for LDL-C was 1.2%, and the correlation was y = 0.990x + 3.361 (r = 0.990). These results met the acceptable range of accuracy prescribed by the National Cholesterol Education Program. Additionally, adLDL-Ch levels were correlated with LDL-C levels measured by the 2 homogeneous assays (r > 0.967) and the calculation methods (r > 0.939), in serum samples from patients with hypertriglyceridemia. Conclusions AEX-HPLC is a reliable method for measuring LDL-C levels for CVD risk in daily clinical laboratory analyses.

scholarly journals IFCC Reference System for Measurement of Hemoglobin A1c in Human Blood and the National Standardization Schemes in the United States, Japan, and Sweden: A Method-Comparison Study

2004 ◽  
Vol 50 (1) ◽  
pp. 166-174 ◽  
Author(s):  
Wieland Hoelzel ◽  
Cas Weykamp ◽  
Jan-Olof Jeppsson ◽  
Kor Miedema ◽  
John R Barr ◽  
...  
Keyword(s):  
Reference System ◽  
Clinical Chemistry ◽  
Method Comparison ◽  
Reference Method ◽  
The United States ◽  
Reference Laboratory ◽  
Regression Equations ◽  
National Programs ◽  
Method Comparison Study ◽  
The Relationship

Abstract Background: The national programs for the harmonization of hemoglobin (Hb)A1c measurements in the US [National Glycohemoglobin Standardization Program (NGSP)], Japan [Japanese Diabetes Society (JDS)/Japanese Society of Clinical Chemistry (JSCC)], and Sweden are based on different designated comparison methods (DCMs). The future basis for international standardization will be the reference system developed by the IFCC Working Group on HbA1c Standardization. The aim of the present study was to determine the relationships between the IFCC Reference Method (RM) and the DCMs. Methods: Four method-comparison studies were performed in 2001–2003. In each study five to eight pooled blood samples were measured by 11 reference laboratories of the IFCC Network of Reference Laboratories, 9 Secondary Reference Laboratories of the NGSP, 3 reference laboratories of the JDS/JSCC program, and a Swedish reference laboratory. Regression equations were determined for the relationship between the IFCC RM and each of the DCMs. Results: Significant differences were observed between the HbA1c results of the IFCC RM and those of the DCMs. Significant differences were also demonstrated between the three DCMs. However, in all cases the relationship of the DCMs with the RM were linear. There were no statistically significant differences between the regression equations calculated for each of the four studies; therefore, the results could be combined. The relationship is described by the following regression equations: NGSP-HbA1c = 0.915(IFCC-HbA1c) + 2.15% (r2 = 0.998); JDS/JSCC-HbA1c = 0.927(IFCC-HbA1c) + 1.73% (r2 = 0.997); Swedish-HbA1c = 0.989(IFCC-HbA1c) + 0.88% (r2 = 0.996). Conclusion: There is a firm and reproducible link between the IFCC RM and DCM HbA1c values.

scholarly journals Assessment of Digital PCR as a Primary Reference Measurement Procedure to Support Advances in Precision Medicine

2018 ◽  
Vol 64 (9) ◽  
pp. 1296-1307 ◽  
Author(s):  
Alexandra S Whale ◽  
Gerwyn M Jones ◽  
Jernej Pavšič ◽  
Tanja Dreo ◽  
Nicholas Redshaw ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Copy Number ◽  
Digital Pcr ◽  
Measurement Procedure ◽  
Patient Treatment ◽  
Molecular Diagnostic ◽  
Reference Measurement ◽  
Reference Measurement Procedure ◽  
Wide Range ◽  
Primary Reference

Abstract BACKGROUND Genetic testing of tumor tissue and circulating cell-free DNA for somatic variants guides patient treatment of many cancers. Such measurements will be fundamental in the future support of precision medicine. However, there are currently no primary reference measurement procedures available for nucleic acid quantification that would support translation of tests for circulating tumor DNA into routine use. METHODS We assessed the accuracy of digital PCR (dPCR) for copy number quantification of a frequently occurring single-nucleotide variant in colorectal cancer (KRAS c.35G>A, p.Gly12Asp, from hereon termed G12D) by evaluating potential sources of uncertainty that influence dPCR measurement. RESULTS Concentration values for samples of KRAS G12D and wild-type plasmid templates varied by <1.2-fold when measured using 5 different assays with varying detection chemistry (hydrolysis, scorpion probes, and intercalating dyes) and <1.3-fold with 4 commercial dPCR platforms. Measurement trueness of a selected dPCR assay and platform was validated by comparison with an orthogonal method (inductively coupled plasma mass spectrometry). The candidate dPCR reference measurement procedure showed linear quantification over a wide range of copies per reaction and high repeatability and interlaboratory reproducibility (CV, 2%–8% and 5%–10%, respectively). CONCLUSIONS This work validates dPCR as an SI-traceable reference measurement procedure based on enumeration and demonstrates how it can be applied for assignment of copy number concentration and fractional abundance values to DNA reference materials in an aqueous solution. High-accuracy measurements using dPCR will support the implementation and traceable standardization of molecular diagnostic procedures needed for advancements in precision medicine.

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