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Fu W, Yue Y, Song Y, Zhang S, Shi J, Zhao R, Wang Q, Zhang R. Comparable analysis of six immunoassays for carcinoembryonic antigen detection. Heliyon 2024; 10:e25158. [PMID: 38322892 PMCID: PMC10845681 DOI: 10.1016/j.heliyon.2024.e25158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
Objective This study aimed to assess the current status of carcinoembryonic antigen (CEA) detection. We evaluated the correlation, consistency, and comparability of CEA results among six automated immunoassays, and combined with the results of CEA trueness verification of the Beijing Center for Clinical Laboratories (BCCL) for further analysis. Methods Abbott Architect i2000, Beckman DxI800, Roche Cobas E601, Diasorin Liaison XL, Maccura IS1200, and Autolumo A2000 were used to detect 40 individual serum CEA samples. Taking the optimal analytical quality specifications calculated from data on biological variation as the evaluation criterion. Passing-Bablok regression and Bland-Altman analysis were performed between each assay and all-assays median values to evaluate the correlation and relative difference. The concordance correlation coefficient (CCC) was used for consistency analysis. Additionally, the trueness verification program used samples at three concentration levels to assess the bias, coefficient of variation (CV), and total error (TE) between the average measured values and the target value. Results The Spearman's rank correlation coefficient (rs) was ≥0.996 and the CCC ranged between 0.9448 and 0.9990 for each assay vs. all-assays median. Considering the all-assays median value of each sample as a reference, there were proportional and systematic differences according to the Passing-bablok regression analysis. The relative difference of the four assays (Abbott Architect i2000, Autolumo A2000, Diasorin Liaison XL, and Maccura IS1200) met the optimal analytical quality specifications. On the other hand, Beckman DxI800 (13.2 %) and Roche Cobas E601 (-9.0 %) were only able to fulfill the desirable analytical quality specifications. The average pass rates for bias, CV, and TE of the trueness verification program were 80 %, 98 %, and 96 %, respectively. Conclusions The six automated immunoassays vs. all-assays median have a good correlation in CEA detection. However, there is a lack of comparability of CEA results. Further improvements are needed in harmonization among CEA detections.
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Affiliation(s)
- Wenxuan Fu
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Yuhong Yue
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Yichuan Song
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Shunli Zhang
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Jie Shi
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Rui Zhao
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Qingtao Wang
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Rui Zhang
- Department of Clinical Laboratory, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
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Van HT, Tran VT, Ha MT, Vu QH. Model of implementing proficiency testing in Vietnam, a developing country. Pract Lab Med 2023; 37:e00339. [PMID: 37886110 PMCID: PMC10598689 DOI: 10.1016/j.plabm.2023.e00339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/24/2023] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
Backgrounds and aims The aim of this study is to provide a good approach for a quantitative EQA scheme assigned value with limited resources. Materials and methods Twelve lyophilized EQA items were distributed to participants in 2021 from North to Southeast Vietnam to measure the concentration of nine parameters, including glucose, urea, creatinine, cholesterol, triglyceride, uric acid, AST, ALT, and GGT. The consensus value of the expert group and all participants were calculated and statistically compared to choose the most appropriate consensus value. Results Fifty-nine laboratories attended the EQA scheme, including an expert group using automatic biochemistry analyzers (AAs) and all participants with auto and semi-auto biochemistry (SAA) analyzers. Consensus values of six per nine parameters were different between the two groups for at least two EQA items, including glucose, creatinine, cholesterol, uric acid, AST, and ALT. The coefficients of variation of glucose, urea, creatinine, triglycerides, uric acid, and GGT in the expert group were significantly lower than those in all the participants. Conclusion Using the consensus values of expert groups as the assigned values of the EQA program is a relevant strategy to increase testing quality in developing countries with limited resources, such as Vietnam.
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Affiliation(s)
- Hy Triet Van
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
- University Medical Center Ho Chi Minh City, Viet Nam
- Quality Control Center for Medical Laboratory Under Ministry of Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Van Thanh Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
- GIC Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Manh Tuan Ha
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
- University Medical Center Ho Chi Minh City, Viet Nam
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Long Q, Qi T, Liu Z, Wang J, Zhao H, Zeng J, Zhang T, Yan Y, Zhou W, Zhang J, Chen W, Zhang C. The consistency of aminotransferase analysis in China: a comparison of six mainstream aminotransferase routine methods and recalibration using human pooled serum preparations supplemented with human recombinant aminotransferases. Scandinavian Journal of Clinical and Laboratory Investigation 2022; 82:58-67. [DOI: 10.1080/00365513.2022.2025895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Qichen Long
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China
| | - Tianqi Qi
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China
| | - Zhenni Liu
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China
| | - Jing Wang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Haijian Zhao
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Jie Zeng
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China
| | - Ying Yan
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Wenxiang Chen
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, People's Republic of China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China
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Xia Y, Li M, Li B, Xue H, Lin Y, Li J, Ji L. Sigma metrics application for validated and non-validated detecting systems performance assessment. J Clin Lab Anal 2020; 35:e23676. [PMID: 33314338 PMCID: PMC7957966 DOI: 10.1002/jcla.23676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/27/2020] [Accepted: 11/22/2020] [Indexed: 12/14/2022] Open
Abstract
Background Sigma metrics provide an objective and quantitative methodology for analytical quality evaluation of clinical laboratory. This study investigated the testing performance of validated systems and non‐validated systems based on sigma metrics, and explored the major parameters affecting the system performance. Methods Sigma metrics were evaluated by six biochemistry assays based on Beckman and Mindray validated and non‐validated systems through crossing the reagents and analyzers. Imprecision and bias were assessed for all assays based on trueness programs organized by National Centre for Clinical Laboratory. Total error allowance obtained from the Chinese Ministry of Health Clinical Laboratory Centre Industry Standard (WS/T403‐2012). Results The imprecision for all systems meets the quality specifications except TP assay (2.19%) detected by Mindray non‐validated system, and the bias for four assays measured by non‐validated systems cannot fulfill the criterion, including lactate dehydrogenase (LDH), total protein (TP), triglycerides (TG), and glucose (GLU). Higher biases were detected in six assays at different levels among non‐validated and validated systems. Systems performed poorly or unacceptably for TP assay with sigma metrics lower than 3 except Mindray non‐validated system. The sigma metrics for other assays with four systems were greater than 3 except the LDH evaluated on Mindray non‐validated systems. Conclusion Non‐validated systems may introduce performance uncertainty compared with validated systems based on sigma metrics evaluation, and lower bias was provided by validated systems. The performance of non‐validated systems should be evaluated thoroughly in the clinical laboratory before they were adopted for routine use.
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Affiliation(s)
- Yong Xia
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Mingyang Li
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Bowen Li
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hao Xue
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yu Lin
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jie Li
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| | - Ling Ji
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
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Yan Y, Pu Y, Zeng J, Zhang T, Zhou W, Zhang J, Wang J, Zhang C, Chen W, Zhang C. Evaluation of serum electrolytes measurement through the 6-year trueness verification program in China. Clin Chem Lab Med 2020; 59:107-116. [PMID: 32721926 DOI: 10.1515/cclm-2020-0355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/08/2020] [Indexed: 11/15/2022]
Abstract
Objectives The National Center for Clinical Laboratories (NCCL) in China initiated a serum electrolyte trueness verification (ETV) program in 2014 for measurement standardization. Methods Every year, two levels of fresh frozen commutable serum samples determined by inductively coupled plasma mass spectrometry (ICP-MS) reference methods were transported to participating clinical laboratories for the measurement of sodium, potassium, calcium and magnesium. Both samples were measured 15 times in 3 days, and the mean values and coefficient variations (CVs) were calculated from the results. The tolerance limits of trueness (bias), precision (CV) and accuracy (TE) based on the biological variation database were used as the evaluation criteria. The overall trend of the ETV program over 6 years was surveyed by calculating the pass rates of the participating laboratories. The mean bias, inter-laboratory CV, and TE of all laboratory results were analysed. Furthermore, homogeneous and heterogeneous systems were compared, and the bias and CV results of mainstream analysis systems were analysed. Results Pass rates of the three quality specifications increased, and the overall mean bias and inter-laboratory CVs decreased. The homogeneous system was superior to the heterogeneous system for calcium and magnesium measurements. For sodium, potassium, calcium and magnesium, the minimum bias corresponded to Hitachi, Siemens, Beckman AU and Roche, respectively. For inter-laboratory robust CVs, no obvious differences were observed between each peer group. Conclusions The commutable ETV materials assigned via reference methods can evaluate the accuracy and reproducibility of an individual laboratory and the calibration traceability and uniformity between laboratories for measurements.
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Affiliation(s)
- Ying Yan
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Yungang Pu
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Jie Zeng
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Jing Wang
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Chao Zhang
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wenxiang Chen
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National, Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
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Wang J, Wang Y, Zhang T, Zeng J, Zhao H, Guo Q, Yan Y, Zhang J, Zhou W, Chen W, Zhang C. Evaluation of serum alkaline phosphatase measurement through the 4-year trueness verification program in China. Clin Chem Lab Med 2019; 56:2072-2078. [PMID: 30226202 DOI: 10.1515/cclm-2018-0399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/03/2018] [Indexed: 11/15/2022]
Abstract
Background Alkaline phosphatase (ALP) is critical for various diseases. The International Federation of Clinical Chemistry and Laboratory Medicine had recommended the new reference procedure in 2011, but many manufacturers did not trace results to the higher procedure. Since 2012, the National Center for Clinical Laboratories (NCCL) in China has organized the trueness verification program (TV) with commutable materials. The present study summarizes the 4-year TV program to give an overview of the measurement standardization for ALP results. Methods Commutable serum-based materials with different concentrations were prepared and sent to participating laboratories. The target values were assigned by the reference lab network. Results The analytical performance was evaluated according to three indexes: trueness (bias), imprecision (CV) and accuracy (total error [TE]). The number of participating laboratories increased from 115 in 2012 to 287 in 2016. The pass rates of precision for homogeneous and heterogeneous systems were all above 85% over the 4 years; however, the pass rates of bias were much lower (<50%). Among the homogeneous systems, Roche Cobas/Modular had an obvious negative bias, whereas the mean positive bias for Beckman AU was prominent. As to the heterogeneous systems, the pass rates of bias for Sichuan Maccura (57.1%-78.6%) were higher than Roche Cobas/Modular (4.4%-33.9%) and Beckman AU (35.7%-64.8%). Conclusions The PT/EQA program with commutable materials can be used to assess the trueness against target values assigned by reference procedures. For ALP, homogeneous systems did not perform better than heterogeneous systems. The bias for ALP performance was notable and was the main obstacle to its standardization in China.
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Affiliation(s)
- Jing Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Yufei Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Beijing, P.R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Jie Zeng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Haijian Zhao
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Qi Guo
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Beijing, P.R. China
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China
| | - Wenxiang Chen
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Beijing, P.R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongcheng District, Beijing 100730, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Dongcheng District, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Beijing, P.R. China, Phone: +8601058115059
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7
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Li R, Wang T, Gong L, Peng P, Yang S, Zhao H, Xiong P. Comparative analysis of calculating sigma metrics by a trueness verification proficiency testing-based approach and an internal quality control data inter-laboratory comparison-based approach. J Clin Lab Anal 2019; 33:e22989. [PMID: 31386228 PMCID: PMC6868403 DOI: 10.1002/jcla.22989] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/02/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction Two methods were compared for evaluating the sigma metrics of clinical biochemistry tests using two different allowable total error (TEa) specifications. Materials and methods The imprecision (CV%) and bias (bias%) of 19 clinical biochemistry analytes were calculated using a trueness verification proficiency testing (TPT)‐based approach and an internal quality control data inter‐laboratory comparison (IQC)‐based approach, respectively. Two sources of total allowable error (TEa), the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) and the People's Republic of China Health Industry Standard (WS/T 403‐2012), were used to calculate the sigma metrics (σCLIA, σWS/T). Sigma metrics were calculated to provide a single value for assessing the quality of each test based on a single concentration level. Results For both approaches, σCLIA > σWS/T in 18 out of 19 assays. For the TPT‐based approach, 16 assays showed σCLIA > 3, and 12 assays showed σWS/T > 3. For the IQC‐based approach, 19 and 16 assays showed σCLIA > 3 and σWS/T > 3, respectively. Conclusions Both methods can be used as references for calculating sigma metrics and designing QC schedules in clinical laboratories. Sigma metrics should be evaluated comprehensively by different approaches.
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Affiliation(s)
- Runqing Li
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Tengjiao Wang
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lijun Gong
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Peng Peng
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Song Yang
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Haibin Zhao
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Pan Xiong
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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Zhao HJ, Zhang TJ, Zeng J, Hu CH, Ma R, Zhang CB. Investigation and Analysis of Hemoglobin A1c Measurement Systems' Performance for 135 Laboratories in China. Chin Med J (Engl) 2018; 130:1079-1084. [PMID: 28469104 PMCID: PMC5421179 DOI: 10.4103/0366-6999.204932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Hemoglobin A1c (HbA1c) measurement is of great value for the diagnosis and monitoring of diabetes. Many manufacturers have developed various experiments to determine the HbA1c concentration. However, the longitudinal use of these tests requires strict quality management. This study aimed to analyze the quality of HbA1c measurement systems in China using six sigma techniques to help improve their performances. Methods: A total of 135 laboratories were involved in this investigation in 2015. Bias values and coefficients of variation were collected from an HbA1c trueness verification external quality assessment program and an internal quality control program organized by the National Center of Clinical Laboratories in China. The sigma (σ) values and the quality goal index (QGI) were used to evaluate the performances of different groups, which were divided according to principles and instruments. Results: The majority of participants (88, 65.2%) were scored as “improvement needed (σ < 3)”, suggesting that the laboratories needed to improve their measurement performance. Only 8.2% (11/135) of the laboratories were scored as “world class (σ ≥ 6)”. Among all the 88 laboratories whose σ values were below 3, 52 (59.1%) and 23 (26.1%) laboratories needed to improve measurement precision (QGI <8.0) and trueness (QGI >1.2), respectively; the remaining laboratories (13, 14.8%) needed to improve both measurement precision and trueness. In addition, 16.1% (5/31) and 15.0% (3/20) of the laboratories in “TOSOH” and “ARKRAY” groups, respectively, were scored as “world class”, whereas none of the laboratories in “BIO-RAD” group were scored as “world class”. Conclusions: This study indicated that, although participating laboratories were laboratories with better performance in China, the performances were still unsatisfactory. Actions should be taken to improve HbA1c measurement performance before we can include HbA1c assays in diabetes diagnosis in China.
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Affiliation(s)
- Hai-Jian Zhao
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
| | - Tian-Jiao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
| | - Jie Zeng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
| | - Cui-Hua Hu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
| | - Rong Ma
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
| | - Chuan-Bao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing 100730, China
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Tong Q, Chen B, Zhang R, Zuo C. Standardization of clinical enzyme analysis using frozen human serum pools with values assigned by the International Federation of Clinical Chemistry and Laboratory Medicine reference measurement procedures. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 78:74-80. [PMID: 29226724 DOI: 10.1080/00365513.2017.1413715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Variation in clinical enzyme analysis, particularly across different measuring systems and laboratories, represents a critical but long-lasting problem in diagnosis. Calibrators with traceability and commutability are imminently needed to harmonize analysis in laboratory medicine. Fresh frozen human serum pools were assigned values for alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatine kinase (CK) and lactate dehydrogenase (LDH) by six laboratories with established International Federation of Clinical Chemistry and Laboratory Medicine reference measurement procedures. These serum pools were then used across 76 laboratories as a calibrator in the analysis of five enzymes. Bias and imprecision in the measurement of the five enzymes tested were significantly reduced by using the value-assigned serum in analytical systems with open and single-point calibration. The median (interquartile range) of the relative biases of ALT, AST, GGT, CK and LDH were 2.0% (0.6-3.4%), 0.8% (-0.8-2.3%), 1.0% (-0.5-2.0%), 0.2% (-0.3-1.0%) and 0.2% (-0.9-1.1%), respectively. Before calibration, the interlaboratory coefficients of variation (CVs) in the analysis of patient serum samples were 8.0-8.2%, 7.3-8.5%, 8.1-8.7%, 5.1-5.9% and 5.8-6.4% for ALT, AST, GGT, CK and LDH, respectively; after calibration, the CVs decreased to 2.7-3.3%, 3.0-3.6%, 1.6-2.1%, 1.8-1.9% and 3.3-3.5%, respectively. The results suggest that the use of fresh frozen serum pools significantly improved the comparability of test results in analytical systems with open and single-point calibration.
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Affiliation(s)
- Qing Tong
- a Beijing Center for Clinical Laboratories , Beijing Chao-Yang Hospital Affiliated to Capital Medical University , Beijing , China
| | - Baorong Chen
- b Department of Laboratory Medicine , Beijing Aerospace General Hospital , Beijing , China
| | - Rui Zhang
- c Department of Clinical Laboratory , Beijing Chao-Yang Hospital Affiliated to Capital Medical University , Beijing , China
| | - Chang Zuo
- c Department of Clinical Laboratory , Beijing Chao-Yang Hospital Affiliated to Capital Medical University , Beijing , China
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