How to define a significant deviation from the expected internal quality control result

Author(s):  
Ferruccio Ceriotti ◽  
Duilio Brugnoni ◽  
Sonia Mattioli

AbstractInternal quality control (IQC) is an everyday practice described in several documents. Its planning requires the definition of quality goals and a documentation system able to provide alarms as soon as the goals are not reached. We propose the use of the uncertainty approach to develop an effective alarm system.The use of the uncertainty information to verify the conformity to specifications is described. A top-down approach to the definition of the uncertainty of the method is described. Once the uncertainty is calculated, the complete measurement result (result±expanded uncertainty) is compared with the maximum permissible error (quality goal). An alternative and more immediate presentation is obtained defining an “acceptance zone” derived from the maximum permissible error reduced on either sides by expanded uncertainty. This approach is applied to two analytes: glucose and creatinine.The relationship between quality goal and expanded uncertainty defines the width of the acceptance zone; if uncertainty is equal or larger than the quality goal, the goal is not attainable.The proposed approach uses an information, expanded uncertainty, that each laboratory seeking ISO 15189 accreditation should already have. The data presentation is immediate and easy to interpret allowing a direct comparison between the performance of the method and the quality goals.

2007 ◽  
Vol 12 (7) ◽  
pp. 369-375 ◽  
Author(s):  
Xavier Fuentes-Arderiu ◽  
Joan Batista-Castellví ◽  
Francesca Canalias ◽  
Dolors Dot-Bach ◽  
Mariano Martínez-Casademont ◽  
...  

2013 ◽  
Vol 66 (12) ◽  
pp. 1027-1032 ◽  
Author(s):  
Helen Kinns ◽  
Sarah Pitkin ◽  
David Housley ◽  
Danielle B Freedman

There is a wide variation in laboratory practice with regard to implementation and review of internal quality control (IQC). A poor approach can lead to a spectrum of scenarios from validation of incorrect patient results to over investigation of falsely rejected analytical runs. This article will provide a practical approach for the routine clinical biochemistry laboratory to introduce an efficient quality control system that will optimise error detection and reduce the rate of false rejection. Each stage of the IQC system is considered, from selection of IQC material to selection of IQC rules, and finally the appropriate action to follow when a rejection signal has been obtained. The main objective of IQC is to ensure day-to-day consistency of an analytical process and thus help to determine whether patient results are reliable enough to be released. The required quality and assay performance varies between analytes as does the definition of a clinically significant error. Unfortunately many laboratories currently decide what is clinically significant at the troubleshooting stage. Assay-specific IQC systems will reduce the number of inappropriate sample-run rejections compared with the blanket use of one IQC rule. In practice, only three or four different IQC rules are required for the whole of the routine biochemistry repertoire as assays are assigned into groups based on performance. The tools to categorise performance and assign IQC rules based on that performance are presented. Although significant investment of time and education is required prior to implementation, laboratories have shown that such systems achieve considerable reductions in cost and labour.


2018 ◽  
Vol 33 (1) ◽  
pp. e22643 ◽  
Author(s):  
Huizhen Sun ◽  
Wei Wang ◽  
Haijian Zhao ◽  
Chuanbao Zhang ◽  
Falin He ◽  
...  

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