scholarly journals Variability of cycle threshold values in an external quality assessment scheme for detection of the SARS-CoV-2 virus genome by RT-PCR

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Christoph Buchta ◽  
Irene Görzer ◽  
Peter Chiba ◽  
Jeremy V. Camp ◽  
Heidemarie Holzmann ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Clinical Decision Making ◽  
Health Management ◽  
External Quality Assessment ◽  
Virus Genome ◽  
Rt Pcr ◽  
External Quality ◽  
External Quality Assessment Scheme ◽  
Cycle Threshold ◽  
Quantitative Results

AbstractObjectivesThe qualitative results of SARS-CoV-2 specific real-time reverse transcription (RT) PCR are used for initial diagnosis and follow-up of Covid-19 patients and asymptomatic virus carriers. However, clinical decision-making and health management policies often are based additionally on cycle threshold (Ct) values (i.e., quantitative results) to guide patient care, segregation and discharge management of individuals testing positive. Therefore, an analysis of inter-protocol variability is needed to assess the comparability of the quantitative results.MethodsCt values reported in a SARS-CoV-2 virus genome detection external quality assessment challenge were analyzed. Three positive and two negative samples were distributed to participating test laboratories. Qualitative results (positive/negative) and quantitative results (Ct values) were assessed.ResultsA total of 66 laboratories participated, contributing results from 101 distinct test systems and reporting Ct values for a total of 92 different protocols. In all three positive samples, the means of the Ct values for the E-, N-, S-, RdRp-, and ORF1ab-genes varied by less than two cycles. However, 7.7% of reported results deviated by more than ±4.0 (maximum 18.0) cycles from the respective individual means. These larger deviations appear to be systematic errors.ConclusionsIn an attempt to use PCR diagnostics beyond the identification of infected individuals, laboratories are frequently requested to report Ct values along with a qualitative result. This study highlights the limitations of interpreting Ct values from the various SARS-CoV genome detection protocols and suggests that standardization is necessary in the reporting of Ct values with respect to the target gene.

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 >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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