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Kouassi KC, Dorkenoo AM, Gbada K, Afanyibo YG, Têko M, Koura A. The Togo national proficiency test pilot programme for basic clinical chemistry tests. Afr J Lab Med 2022; 11:1565. [PMID: 35811750 PMCID: PMC9257935 DOI: 10.4102/ajlm.v11i1.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/09/2022] [Indexed: 11/12/2022] Open
Abstract
Background A national proficiency test (PT) programme is not currently implemented in most low-income countries. However, participation in such PT programmes assists improves test performance and result accuracy. Objective This study assessed how well 11 government hospital laboratories performed 18 basic clinical chemistry tests and identified areas needing improvement. Methods A cross-sectional study was carried out by the Division of Laboratories of the Ministry of Health of Togo from 01 July 2016 to 31 December 2016. The test performance was evaluated using panels provided by One World Accuracy, Canada (Vancouver). The Clinical Laboratory Improvement Amendments criteria were used in evaluating the laboratories, and their success rates were compared with the World Health Organization Regional Office for Africa’s target of 80%. Results The overall rate of acceptable results at the laboratories was over 80% for glucose, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, alkaline phosphatase and triglycerides tests. The laboratories using fully automated spectrophotometers had an acceptable results rate of 89% (p = 0.001). The overall performance of the laboratories by cycles varied from 71% to 82%. Conclusion This national PT programme identified the tests, which laboratories must improve their performance (urea, creatinine, uric acid, bilirubin, cholesterol, total protein, calcium, magnesium, phosphorus). It demonstrated the need for the use of routine appropriate internal quality control in all laboratories. The proficiency test programme should be extended to all clinical laboratories and target all biology disciplines.
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Affiliation(s)
- Kafui C Kouassi
- Unity of External Quality Assessement, Division of Laboratories, Ministry of Health and Public Hygiene, Lomé, Togo
- Medical and Biological Analysis-Biochemistry, Higher School of Biological and Food Techniques, University of Lomé, Lomé, Togo
| | - Améyo M Dorkenoo
- Division of Laboratories, Ministry of Health and Public Hygiene, Lomé, Togo
- Department of Health Sciences, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Komivi Gbada
- Division of Laboratories, Ministry of Health and Public Hygiene, Lomé, Togo
- Lomé Commune Regional Hospital, Ministry of Health and Public Hygiene, Lomé, Togo
| | - Yaovi-Gameli Afanyibo
- Division of Laboratories, Ministry of Health and Public Hygiene, Lomé, Togo
- National Institute of Hygene, Ministry of Health and Public Hygiene, Lomé, Togo
| | - Minogblon Têko
- Division of Laboratories, Ministry of Health and Public Hygiene, Lomé, Togo
- Bè Secondary Hospital, Ministry of Health and Public Hygiene, Lomé, Togo
| | - Adjane Koura
- Division of Laboratories - RESAOLAB, Ministry of Health and Public Hygiene, Lomé, Togo
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Kim S, Lee K, Park HD, Lee YW, Chun S, Min WK. Schemes and Performance Evaluation Criteria of Korean Association of External Quality Assessment (KEQAS) for Improving Laboratory Testing. Ann Lab Med 2021; 41:230-239. [PMID: 33063686 PMCID: PMC7591290 DOI: 10.3343/alm.2021.41.2.230] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/07/2020] [Accepted: 09/19/2020] [Indexed: 12/11/2022] Open
Abstract
External quality assessment (EQA) is important for evaluating clinical laboratories and enhancing their testing quality. EQA schemes are variable; thus, it is crucial that the EQA organizers share their experiences to continuously improve the EQA scheme. The Korean Association of External Quality Assessment Service (KEQAS) has been the leading, authorized EQA institute for the standardization and quality management of laboratory testing in Korean medical institutions since 1976. The EQA scheme underwent a major change in 2016, and the number of EQA programs increased significantly since then. The key changes implemented in EQA scheme include a fully computerized assessment to accelerate feedback and unification of the testing and reporting methods. We provide an overview of the EQA schemes and performance evaluation criteria of the KEQAS and suggest directions for achieving the global harmonization of EQA.
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Affiliation(s)
- Sollip Kim
- Department of Laboratory Medicine, Inje University, Ilsan Paik Hospital, Goyang, Korea
| | - Kyunghoon Lee
- Department of Laboratory Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong-Wha Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sail Chun
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Won-Ki Min
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
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Milevoj Kopcinovic L, Brcic M, Vrtaric A, Unic A, Bozovic M, Nikolac Gabaj N, Miler M, Culej J. Long-term stability of clinically relevant chemistry analytes in pleural and peritoneal fluid. Biochem Med (Zagreb) 2020; 30:020701. [PMID: 32292279 PMCID: PMC7138007 DOI: 10.11613/bm.2020.020701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/13/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Our aim was to investigate the stability of clinically relevant analytes in pleural and peritoneal fluids stored in variable time periods and variable storage temperatures prior to analysis. Materials and methods Baseline total proteins (TP), albumin (ALB), lactate dehydrogenase (LD), cholesterol (CHOL), triglycerides (TRIG), creatinine (CREA), urea, glucose and amylase (AMY) were measured using standard methods in residual samples from 29 pleural and 12 peritoneal fluids referred to our laboratory. Aliquots were stored for 6 hours at room temperature (RT); 3, 7, 14 and 30 days at - 20°C. At the end of each storage period, all analytes were re-measured. Deviations were calculated and compared to stability limits (SL). Results Pleural fluid TP and CHOL did not differ in the observed storage periods (P = 0.265 and P = 0.170, respectively). Statistically significant differences were found for ALB, LD, TRIG, CREA, urea, glucose and AMY. Peritoneal fluid TP, ALB, TRIG, urea and AMY were not statistically different after storage, contrary to LD, CHOL, CREA and glucose. Deviations for TP, ALB, CHOL, TRIG, CREA, urea and AMY in all storage periods tested for both serous fluids were within the SL. Deviations exceeding SL were observed for LD and glucose when stored for 3 and 7 days at - 20°C, respectively. Conclusions TP, ALB, CHOL, TRIG, CREA, urea and AMY are stable in serous samples stored up to 6 hours at RT and/or 30 days at - 20°C. Glucose is stable up to 6 hours at RT and 3 days at - 20°C. The stability of LD in is limited to 6 hours at RT.
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Affiliation(s)
- Lara Milevoj Kopcinovic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Marija Brcic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Alen Vrtaric
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Adriana Unic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Marija Bozovic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Nora Nikolac Gabaj
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Marijana Miler
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Jelena Culej
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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Kim S, Yun YM, Kim H, Um TH, Chang J, Jeong H, Lee KS, Chun S, Choi YJ, Heo JH, Han TH. The New Diagnosis-Related Group Reimbursement System and Laboratory Test Quality in Korea: Analysis of External Quality Assessment Results. Healthcare (Basel) 2020; 8:E127. [PMID: 32392746 PMCID: PMC7349770 DOI: 10.3390/healthcare8020127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/20/2020] [Accepted: 05/01/2020] [Indexed: 12/31/2022] Open
Abstract
Korea introduced a new diagnosis-related group (NDRG), which is a mixed-bundle reimbursement system. We evaluated the effects of NDRGs on laboratory test quality by analyzing data over three years (2016-2018) from the Korean Association of External Quality Assessment Service (KEQAS). A total of 42 NDRG-participating hospitals (CASE), 84 non-participating similar size-hospitals (CON-1), and 42 tertiary hospitals (CON-2) were included. We assumed the proportion of KEQAS results with a larger than 2 standard deviation index (SDI) to be a bad laboratory quality marker (BLQM). CASE BLQMs were lower than CON-1 BLQMs for more than 2 years in alkaline phosphatase (ALP), alanine aminotransferase (ALT), chloride, glucose, sodium, and total protein, and higher in creatinine. CASE BLQMs were higher than CON-2 BLQMs for more than 2 years in ALP, chloride, creatinine, glucose, lactate dehydrogenase (LDH), phosphorus, potassium, sodium, total calcium, total cholesterol, triglyceride, and uric acid. Mean SDIs for general chemistry tests were not significantly different depending on NDRG participation. However, the NDRG is currently a pilot program that compensates the amount of each institution's reimbursement based on the fee-for-service system, and most participants were public hospitals. Thus, the effects of NDRGs on laboratory test quality should be re-evaluated after the NDRG program has stabilized and more private hospitals are participating.
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Affiliation(s)
- Sollip Kim
- Department of Laboratory Medicine, Inje University, Ilsan Paik Hospital, Goyang 10380, Korea; (S.K.); (T.-H.U.); (J.C.)
| | - Yeo-Min Yun
- Department of Laboratory Medicine, School of Medicine, Konkuk University, Seoul 05030, Korea
| | - Hyeongsu Kim
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul 05030, Korea; (H.J.); (K.S.L.)
| | - Tae-Hyun Um
- Department of Laboratory Medicine, Inje University, Ilsan Paik Hospital, Goyang 10380, Korea; (S.K.); (T.-H.U.); (J.C.)
| | - Jeonghyun Chang
- Department of Laboratory Medicine, Inje University, Ilsan Paik Hospital, Goyang 10380, Korea; (S.K.); (T.-H.U.); (J.C.)
| | - Hojin Jeong
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul 05030, Korea; (H.J.); (K.S.L.)
| | - Kun Sei Lee
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul 05030, Korea; (H.J.); (K.S.L.)
| | - Sail Chun
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul 05505, Korea;
| | - Yong-Jun Choi
- Department of Social and Preventive Medicine, Health Services Research Center, College of Medicine, Hallym University, Chuncheon 24252, Korea;
| | - Jae-Hyeok Heo
- Department of Neurology, Seoul Medical Center, Seoul 02053, Korea;
| | - Tae-Hwa Han
- Health IT Center, College of Medicine, Yonsei University, Seoul 03722, Korea;
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Status of Quality Control for Laboratory Tests of Medical Institutions in Korea: Analysis of 10 Years of Data on External Quality Assessment Participation. Healthcare (Basel) 2020; 8:healthcare8020075. [PMID: 32230819 PMCID: PMC7349217 DOI: 10.3390/healthcare8020075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/16/2022] Open
Abstract
External quality assessment (EQA) is a commonly used tool to track the performance of laboratory tests. In Korea, EQA participation is not mandatory, and even basic data about EQA participation are not available. We used data of a 10-year period extracted from two databases (2009-2018): (1) the database of the National Health Insurance Service to calculate the number of medical institutions that claimed health insurance benefits, and (2) the database of the Korean Association of External Quality Assessment Service to calculate the number of medical institutions participating in EQA. The proportion of institutions that made claims for the performance of laboratory testing throughout the 10 years were 73.6%-76.0% for clinics, 91.9%-97.5% for long-term care hospitals, 97.9%-99.5% for small to medium hospitals, 99.6%-100% for general hospitals, and 100% for tertiary hospitals. The mean EQA participation rate of institutions that performed laboratory testing for the 10 years was 1.9% for clinics, 3.1% for long-term care hospitals, 27.7% for small to medium hospitals, 96.6% for general hospitals, and 100% for tertiary hospitals. The mean EQA participation of clinics, long-term care hospitals, and small to medium hospitals are increasing but is still not sufficient. Regulatory approaches are needed to increase participation rates. This result would be used for health policymaking on the quality improvement of laboratory tests.
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De la Salle B, Meijer P, Thomas A, Simundic AM. Special issue on External Quality Assessment in Laboratory Medicine - current challenges and future trends. Biochem Med (Zagreb) 2017; 27:19-22. [PMID: 28392722 PMCID: PMC5382846 DOI: 10.11613/bm.2017.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
| | - Piet Meijer
- ECAT Foundation, Voorschoten, The Netherlands
| | - Annette Thomas
- WEQAS Quality Laboratory, Cardiff and Vale University Health Board, Llanishen, Cardiff, UK
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia; Editor-in-Chief, Biochemia Medica, Zagreb, Croatia
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