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Liu Z, Jin L, Ma Z, Nizhamuding X, Zeng J, Zhang T, Zhang J, Zhou W, Zhang C. Commutability assessment of candidate reference materials for plasma renin activity measurement: current challenges. Clin Chem Lab Med 2024; 62:67-76. [PMID: 37470745 DOI: 10.1515/cclm-2023-0698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES This study aims to evaluate the commutability of external quality assessment (EQA) materials and candidate reference materials (RMs) for plasma renin activity (PRA) assay. METHODS Commutabilities of 16 candidate RMs were measured along with 40 clinical samples by the four different routine PRA assays, including three LC‒MS/MS assays and one chemiluminescence immunoassay. Sixteen candidate RMs included native/spiked human plasma pools (small-scale pools with <50 individuals) and current EQA materials (large-scale pools with >1,000 individuals). Difference in bias approach and linear regression with prediction interval approach were adopted to determine the commutability. Two-way variance analysis was used to estimate the effects of spiked and pool size on the commutability. Stability and homogeneity studies were performed. RESULTS Precision and correlation performance of all assays was acceptable. In the difference in bias approach, the commutability results were not satisfactory (noncommutability: 14/16) and significant sample-specific effects were detected in assay pairs using different incubation buffers. For the prediction interval approach, no commutability was observed in the spiked small-scale pools; EQA materials (4/9) had more satisfactory commutability among all assays than the small-scale pools (2/7); RMs of large-scale pools tend to have better commutability no matter spiked or not. CONCLUSIONS Commutable RMs were obtainable but challenging. Current EQA materials with relatively good commutability, stability, and homogeneity were appropriate RMs. Large-scale pools are tending to be commutable. Spiking in small-scale pools was not suggested to prepare RMs. MPs adopting a uniform incubation buffer would be preferable for further commutability research.
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Affiliation(s)
- Zhenni Liu
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Lizi Jin
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Zijia Ma
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Xiaerbanu Nizhamuding
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jie Zeng
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
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Liu Z, Jin L, Zeng J, Zhang T, Zhang J, Zhou W, Zhang C. Poor comparability of plasma renin activity measurement in determining patient samples: the status quo and recommendations for harmonization. Clin Chem Lab Med 2023; 61:1770-1779. [PMID: 37053598 DOI: 10.1515/cclm-2023-0117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES This study aims to investigate and update the consistency and comparability of plasma renin activity (PRA) assays in measuring clinical samples. The contributions of recalibration, blank subtraction, and incubation strategies to interchangeability were also explored. METHODS Five different laboratories were evaluated using forty-six individual plasma samples, including four liquid chromatography-tandem mass spectrometry (LC‒MS/MS) assays and one chemiluminescence immunoassay (CLIA). Spearman correlation coefficient (R), Passing-Bablok regression, and Bland‒Altman plot analyses were used to evaluate the consistency among assays. Consistency before and after recalibration, blank subtraction, and incubation strategy unification was compared. RESULTS A good correlation was observed among all assays (R>0.93). None of the samples measured by all assays showed coefficient variation (CV) <10 %, and 37 % of samples showed overall CVs >20 %. The 95 % confidence intervals (CIs) for slopes did not contain 1 for most assay pairs. Large relative biases (-85.1-104.2 %) were found, and 76 % (52-93 %) of samples had unacceptable biases. Recalibration reduced the calibration bias. Ignoring blank subtraction improved the comparability across all assays while unifying incubation did not. CONCLUSIONS The interchangeability of PRA measurement was unsatisfying. Harmonization on calibrator and ignoring blank were recommended. Unifying incubation strategy was unnecessary.
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Affiliation(s)
- Zhenni Liu
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Lizi Jin
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jie Zeng
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Weiyan Zhou
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
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Sang L, Wu C, Chen H, Liu W, Huang D, Yang X, Guo X, Cui R, Wang N, Zhang R, Yue Y, Guo H, Wang M, Miao Y, Wang Q, Zhang S. Commutability evaluation of candidate reference materials and ERM-DA470k/IFCC for immunoglobulin M using two international approaches. J Clin Lab Anal 2023; 37:e24955. [PMID: 37571860 PMCID: PMC10492453 DOI: 10.1002/jcla.24955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 07/02/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND This study aimed to assess the commutability of frozen pooled human serum (PHS), high concentration of Immunoglobulin M (IgM) pure diluted materials (HPDM), commercialized pure materials (CPM), and dilutions of ERM-DA470k/IFCC in IgM detection using the CLSI and IFCC approaches, to support standardization or harmonization of IgM measurement. METHODS Twenty-four serum samples, relevant reference materials (PHS, HPDM, CPM), and different ERM-DA470k/IFCC dilutions were analyzed in triplicate using six routine methods. The commutability of the relevant reference materials was carried out following CLSI EP30-A and IFCC bias analysis. RESULTS According to the CLSI approach, low, medium, and high concentrations of PHS, HPDM, and CPM were commutable on 10, 13, 15, 13, and 8 of 15 assay combinations, respectively. Using the IFCC approach, low, medium, and high concentrations of PHS, HPDM, and CPM were commutable on 10, 11, 9, 15, and 10 of 15 assay combinations, respectively. The ERM-DA470k/IFCC dilutions with D-PBS and RPMI-1640 Medium were commutable on 13 of 15 assay combinations according to CLSI and were commutable on all 15 assay combinations using IFCC approach. CONCLUSIONS High concentration of PHS were commutable on all six detection systems using the CLSI approach. Low and medium concentration of PHS showed unsatisfied commutability. HPDM, not CPM have good commutability, has the potential to become reference materials. ERM-DA470k/IFCC diluted with different medium showed different commutability.
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Affiliation(s)
- Lu Sang
- Department of Clinical LaboratoryBeijing Huairou HospitalBeijingChina
| | - Chunying Wu
- Department of Clinical Laboratory, Beijing Luhe HospitalCapital Medical UniversityBeijingChina
| | - Huijuan Chen
- Department of Clinical LaboratoryBeijing Huairou HospitalBeijingChina
| | - Wei Liu
- Department of Clinical Laboratory, Beijing Luhe HospitalCapital Medical UniversityBeijingChina
| | - Dawei Huang
- Department of Clinical LaboratoryBeijing Longfu HospitalBeijingChina
| | - Xi Yang
- Department of Clinical LaboratoryBeijing Huairou HospitalBeijingChina
| | - Xinrui Guo
- Department of Respiratory and Critical Care MedicineChina‐Japan Friendship HospitalBeijingChina
| | - Ruifang Cui
- Department of Clinical LaboratoryHeping Hospital Affiliated to Changzhi Medical CollegeChangzhiChina
| | - Ning Wang
- Department of Clinical Laboratory, Beijing Chaoyang HospitalThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Rui Zhang
- Department of Clinical Laboratory, Beijing Chaoyang Hospital, Beijing Center for Clinical LaboratoriesThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Yuhong Yue
- Department of Clinical Laboratory, Beijing Chaoyang Hospital, Beijing Center for Clinical LaboratoriesThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Hong Guo
- Department of Clinical LaboratoryHeji Hospital Affiliated to Changzhi Medical CollegeChangzhiChina
| | - Minghao Wang
- Department of Clinical Laboratory, Beijing Chaoyang HospitalThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Yutong Miao
- Department of Clinical Laboratory, Beijing Chaoyang HospitalThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Qingtao Wang
- Department of Clinical Laboratory, Beijing Chaoyang Hospital, Beijing Center for Clinical LaboratoriesThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
| | - Shunli Zhang
- Department of Clinical Laboratory, Beijing Chaoyang Hospital, Beijing Center for Clinical LaboratoriesThe Third Clinical Medical College of Capital Medical UniversityBeijingChina
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Jin L, Zhang T, Zhang C. Two comments for the current commutability assessment. Clin Chem Lab Med 2022; 60:e235-e236. [PMID: 35853644 DOI: 10.1515/cclm-2022-0566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Lizi Jin
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, P.R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, P.R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, P.R. China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, P.R. China
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Xing T, Liu J, Sun H, Gao Y, Ju Y, Liu X, Song D. Commutability assessment of reference materials for homocysteine. Clin Chem Lab Med 2022; 60:1562-1569. [PMID: 35977428 DOI: 10.1515/cclm-2022-0388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Commutability of reference materials is essential for ensuring the traceability of patient measurement results and the technical basis for the use of reference materials. Commutability is only relevant for matrixed reference material; it is a prerequisite for the accuracy and authenticity of calibration methods. In this study, we evaluated the commutability of reference materials for homocysteine. METHODS Five conventional measurement methods were applied to simultaneously measure 30 serum samples and seven homocysteine reference materials from the National Institute of Standards and Technology and the National Institute of Metrology. Liquid chromatography tandem-mass spectrometry was used as a reference method. Two methods were used to evaluate the commutability of the seven reference materials according to the Clinical and Laboratory Standards Institute EP30-A and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) commutability assessment document. RESULTS Among 35 combinations of the five conventional methods and seven reference materials, after evaluation in accordance with the EP30-A, the seven reference materials passed the commutability assessment, and 34 combinations were commutable. According to the IFCC, the commutability evaluation of 28 combinations was conclusive (commutable or non-commutable), while results for the remaining seven combinations could not be determined. CONCLUSIONS The homocysteine reference materials showed good commutability. The sensitivity of the measurement procedure, measurement deviation and uncertainty, and differences in the "measurand" selected by different methods may affect the evaluation results. Additionally, different judgment standards for different methods may explain the observed variations in evaluation results.
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Affiliation(s)
- Tongtong Xing
- Division of Chemical Metrology and Analytical Science, National Institute of Metrology (Key Laboratory of Chemical Metrology and Applications on Nutrition and Health for State Market Regulation), Beijing, P.R. China
- School of Chemical Engineering, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Jianyi Liu
- Division of Chemical Metrology and Analytical Science, National Institute of Metrology (Key Laboratory of Chemical Metrology and Applications on Nutrition and Health for State Market Regulation), Beijing, P.R. China
| | - Haofeng Sun
- Division of Chemical Metrology and Analytical Science, National Institute of Metrology (Key Laboratory of Chemical Metrology and Applications on Nutrition and Health for State Market Regulation), Beijing, P.R. China
- School of Chemical and Engineering, Nanjing University of Science and Technology, Nanjing, Jiangsu, P.R. China
| | - Yanhong Gao
- Laboratory Department of the First Medical Center of PLA General Hospital, Beijing, P.R. China
| | - Yi Ju
- Shanghai Center for Clinical Laboratory, Shanghai, P.R. China
| | - Xiaolin Liu
- School of Chemical Engineering, Beijing University of Chemical Technology, Beijing, P.R. China
| | - Dewei Song
- Division of Chemical Metrology and Analytical Science, National Institute of Metrology (Key Laboratory of Chemical Metrology and Applications on Nutrition and Health for State Market Regulation), Beijing, P.R. China
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Deng Y, Liu Q, Liu Z, Zhao H, Zhou W, Zhang C. Commutability Assessment of Processed Human Plasma Samples for Normetanephrine and Metanephrine Measurements Based on the Candidate Reference Measurement Procedure. Ann Lab Med 2022; 42:575-584. [PMID: 35470275 PMCID: PMC9057823 DOI: 10.3343/alm.2022.42.5.575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/23/2021] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background To identify candidate external quality assessment (EQA) materials for normetanephrine and metanephrine measurements, we assessed the commutability of eight processed human plasma samples. The agreement between routine assays and the candidate reference measurement procedure (cRMP) was also evaluated. Methods Fifty-three clinical samples and eight processed plasma samples were prepared. The processed samples included pooled and individual plasma samples spiked with pure normetanephrine and metanephrine and non-spiked pooled and individual plasma samples. The clinical and processed samples were subjected to four routine isotope dilution tandem mass spectrometry assays and cRMP. Commutability was assessed based on two approaches recommended by the CLSI and International Federation of Clinical Chemistry (IFCC). Passing–Bablok regression and Bland–Altman analysis were used to evaluate the agreement between the routine assays and cRMP. Results The commutability results of the CLSI approach were better than those of the IFCC approach. For the CLSI approach, spiked individual plasma samples and spiked high-concentration pooled plasma samples were commutable for all routine assays for both analytes. The non-spiked pooled plasma sample was commutable for two out of four routine assays for metanephrine and three out of four routine assays for normetanephrine. The agreement between the routine assays and the cRMP was satisfactory, except for one routine assay showing significant bias. Conclusions High-concentration spiked pooled plasma samples and spiked individual plasma samples are candidate EQA materials for normetanephrine and metanephrine measurements.
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Affiliation(s)
- Yuhang Deng
- 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, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qingxiang Liu
- 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, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenni Liu
- 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, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haijian Zhao
- 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, 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, 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, China
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Yi X, Wang Y, Zhang T, Zeng J, Zhao H, Zhou W, Zhang J, Yan Y, Chen W, Zhang C. Commutability of possible external quality assessment materials for progesterone measurement. Clin Biochem 2020; 87:39-45. [PMID: 33188771 DOI: 10.1016/j.clinbiochem.2020.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/14/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The commutability of control materials used for external quality assessment (EQA) programs is of great importance. Evaluating the commutability of control materials is crucial to assess their suitability for EQA programs. METHODS Forty-eight individual patient serum samples, commercial EQA samples, human serum pools (HSPs), commercially available sterile filtered charcoal stripped serum (CS) and swine serum were analyzed using the isotope dilution liquid chromatography-tandem mass spectrometry (ID LC-MS/MS) comparative method and six immunoassays for progesterone. The commutability was assessed according to the EP14-A2 guideline and the difference in bias approach, respectively. RESULTS According to the EP14-A2 guideline, HSPs and CS were commutable for all the tested immunoassays, while swine serum showed positive matrix effects in some assays. Based on the difference in bias approach, a large number of inconclusive and noncommutable results appeared. CONCLUSIONS The commutability of the processed materials varied depending on which evaluation approach and criterion was applied. Noncommutability of the EQA materials was observed. And HSPs and CS were possible commutable candidate control materials according to the EP14-A2 guideline.
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Affiliation(s)
- Xilian Yi
- 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, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, PR China
| | - Yufei 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, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, PR 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, PR 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, PR China
| | - Haijian Zhao
- 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, PR 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, PR 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, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, PR China
| | - 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, PR 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, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, PR 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, PR China; Chinese Academy of Medical Sciences and Peking Union Medical College, PR China.
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Vidali M, Carobene A, Apassiti Esposito S, Napolitano G, Caracciolo A, Seghezzi M, Previtali G, Lippi G, Buoro S. Standardization and harmonization in hematology: Instrument alignment, quality control materials, and commutability issue. Int J Lab Hematol 2020; 43:364-371. [PMID: 33174358 DOI: 10.1111/ijlh.13379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In the hub and spoke laboratory network, the number of hematology analyzers (HAs) within each core center has increased, and the control of HAs alignment is becoming necessary requirement to ensure analytical quality. In this scenario, HA alignment can be assessed by analyzing the same control material used for internal quality control on multiple HAs, assuming its commutability. The aim of the study was to verify the applicability of a protocol for the alignment of HAs based on control material rather than on fresh whole-blood samples. METHODS The alignment of five HAs was evaluated for red (RBC, Hb, MCV, RET), white (WBC, NE, LY, MO, EO, BA, IG), and platelet (PLT) series parameters, following a protocol by SIBioC, using human sample (HS) and quality control material (QC), after the verification of commutability, according to the IFCC protocol. Maximum bias was derived from biological variation data. RESULTS A complete alignment between instruments was confirmed for the majority of the parameters investigated both for HS and QC material. Partial misalignments or inconcludent results were instead evident for MCV, MO, EO, BA, and IG. Interestingly, QC material was found to be not commutable for LY, MO, and BA. CONCLUSION The alignment of hematologic analyzers for main cell population parameters may be verified with both QC and HS, displaying consistent results and interpretation. The evaluation for some white series parameters (EO, BA, and IG) is critical, and particular attention must be paid to the values of the material used for the alignment.
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Affiliation(s)
- Matteo Vidali
- Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Anna Carobene
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | | | - Gavino Napolitano
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Michela Seghezzi
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
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Long Q, Qi T, Zhang T, Wang J, Zeng J, Yan Y, Wang M, Huang W, Zhao H, Chen W, Zhang C. Commutability Assessment of Candidate External Quality Assessment Materials for Aminotransferase Activity Measurements Based on Different Approaches in China. Ann Lab Med 2020; 41:68-76. [PMID: 32829581 PMCID: PMC7443529 DOI: 10.3343/alm.2021.41.1.68] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/20/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background Using commutable external quality assessment (EQA) materials is important for monitoring successful harmonization efforts. We assessed the commutability of four human serum pool (HSP) preparations to identify candidate EQA materials for alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity measurement. Methods One set each of 85 clinical samples (CSs) was collected for ALT and AST activity measurement. The 15 candidate EQA materials included four types of HSP preparations (A to D): materials A, C, and D contained human original recombinant (HOR) aminotransferases; materials B was mixed leftover samples. The CSs and 15 candidate EQA materials were analyzed using seven routine assays, and the ln-transformed results were analyzed in 21 assay pairs. Commutability was assessed using Deming regression, with a 95% prediction interval (CLSI approach) and the difference in bias with an error component model (International Federation of Clinical Chemistry and Laboratory Medicine [IFCC] approach). Results For ALT, all materials were commutable for 14–21 assay pairs according to the CLSI and IFCC approaches. For AST, B01–03 showed commutability for 14–21 assay pairs, and C01–03 and D01–03 showed commutability for no less than 10 assay pairs according to the two approaches. A01–06 were commutable for 9–16 assay pairs according to the CLSI approach, but for 6–9 assay pairs according to the IFCC approach. Conclusions Mixed leftover samples showed desirable commutability characteristics as candidate EQA materials for routine aminotransferase activity measurements. Human serum bases supplemented with HOR were commutable for most routine ALT activity measurements.
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Affiliation(s)
- Qichen Long
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P. R. China
| | - Tianqi Qi
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P. R. China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P. R. China
| | - Jing Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, 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 Engineering Research Center of Laboratory Medicine, Beijing, P. R. China
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P. R. China
| | - Meng Wang
- Clinical Laboratory, Department, Beijing Hospital, National Center of Gerontology, Beijing, P. R. China
| | - Wei Huang
- The Ministry of Health Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, P. R. China
| | - Haijian Zhao
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, 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 Engineering Research Center of Laboratory Medicine, Beijing, P. R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P. R. China
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Wang Y, Plebani M, Sciacovelli L, Zhang S, Wang Q, Zhou R. Commutability of external quality assessment materials for point-of-care glucose testing using the Clinical and Laboratory Standards Institute and International Federation of Clinical Chemistry approaches. J Clin Lab Anal 2020; 34:e23327. [PMID: 32342567 PMCID: PMC7439342 DOI: 10.1002/jcla.23327] [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: 09/19/2019] [Revised: 02/21/2020] [Accepted: 03/17/2020] [Indexed: 01/17/2023] Open
Abstract
Objectives The aim of this study was to assess the commutability of three external quality assessment (EQA) materials for point‐of‐care (POC) glucose testing using two approaches, to identify suitable EQA materials to evaluate and monitor the quality of POC testing. Methods Commercial control materials (CCMs), pooled human serum samples (PHSs), and homemade human whole‐blood samples (HWBs) were measured along with 33 individual clinical samples using five POC instruments and a Hitachi 7600 analyzer. Data were analyzed by Deming regression analysis with a 95% prediction interval as described in Clinical and Laboratory Standards Institute (CLSI) EP30‐A, and by difference in bias analysis as described by the International Federation of Clinical Chemistry (IFCC) Working Group on Commutability. Results Using the CLSI approach, HWBs, CCMs, and PHSs were commutable with five, one, and two instruments, respectively. With the IFCC approach, HWBs were commutable with two instruments, while CCMs and PHSs were largely inconclusive or non‐commutable on five instruments. Conclusions HWBs were commutable on all instruments by the CLSI approach and may be a suitable EQA material for POC testing. Although some results differed between the IFCC and CLSI approaches, both indicated that HWBs were far superior to CCMs and PHSs in commutability.
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Affiliation(s)
- Yan Wang
- Department of Laboratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Mario Plebani
- Department of Laboratory Medicine, Padova University Hospital, Padova, Italy
| | - Laura Sciacovelli
- Department of Laboratory Medicine, Padova University Hospital, Padova, Italy
| | - Shunli Zhang
- Department of Laboratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qingtao Wang
- Department of Laboratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Beijing Center for Clinical Laboratories, Beijing, China
| | - Rui Zhou
- Department of Laboratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Yan Y, Pu Y, Long Q, Zhang J, Zhang T, Zhou W, Zeng J, Zhang C, Chen W, Zhang C. Commutability of external quality assessment materials for serum magnesium and calcium measurements. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:404-411. [PMID: 31271069 DOI: 10.1080/00365513.2019.1636404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The commutability of pooled patient sera (PPS) and control materials (CM) should be evaluated to investigate their suitability for use in an external quality assessment (EQA) program. Individual human samples, PPS and CM were analyzed by four routine methods and inductively coupled plasma mass spectrometry reference methods for magnesium and calcium measurements. The commutability was analyzed according to EP14-A3 protocol and the difference in bias approach, respectively. For magnesium measurements, all PPS were commutable and 3/5 CM were commutable for all measurement systems according to the EP14-A3 protocol. For calcium measurements, most PPS were commutable for all measurement systems, but the CM were only commutable with the Cobas c702 system. The IFCC approach produced similar commutability profiles, except that a large number of inconclusive results appeared. The routine methods exhibited excellent linearity and precision. The majority of relative biases between the routine and reference methods were beyond the bias limits. The commutability of the CM and PPS vary depending on which evaluation approach and criterion is applied. Superiority in the commutability of PPS over CM was observed whichever evaluation approach is applied.
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Affiliation(s)
- Ying Yan
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Yungang Pu
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China.,Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Qichen Long
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China.,Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Jiangtao Zhang
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Tianjiao Zhang
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Weiyan Zhou
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Jie Zeng
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Chao Zhang
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China
| | - Wenxiang Chen
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China.,Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories and Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology , Beijing , China.,Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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Li C, Peng M, Xu D, Lu H, Zhou W, Liu Y, Liu X, Chen W. Commutability assessment of reference materials for the enumeration of lymphocyte subsets. Clin Chem Lab Med 2019; 57:697-706. [PMID: 30838835 DOI: 10.1515/cclm-2018-0915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/19/2018] [Indexed: 11/15/2022]
Abstract
Background Flow cytometric enumeration of lymphocyte subsets in peripheral blood can provide important information about immune status. Commutable reference materials (RM) are crucial for maintaining accurate and comparable measurement results over time and space. Commutability assessment of RMs for lymphocyte subsets enumeration has not been reported elsewhere. Methods Lymphocyte subsets were measured in triplicate on 56 patient samples and eight RMs using two measuring systems commonly used in laboratories (FACS Canto II and Cytomics FC500). The first step was to determine the suitability of RMs and comparability of different systems with patient samples. After the requirements of suitability and comparability were met, the second step was to assess commutability following regression approach and difference in bias approach. Results Two RMs were not measurable on FC500 system for CD3-CD16/56+ and CD3-CD19+ percentages. The results of comparability showed no significant difference in the two systems. Eight RMs for CD3+CD4+ cell count, six RMs for CD3+ and CD3+CD8+ percentages, five RMs for CD3-CD16/56+ percentage, and three RMs for CD3-CD19+ percentage were commutable using the two approaches. For CD3+, CD3+CD8+ and CD3-CD19+ percentages, the results of regression approach showed that one RM was non-commutable for each parameter, while the other approach showed that the RM was commutable. Conclusions The suitability of RM and comparability of different measuring systems are prerequisites for assessing commutability. This study indicated that different approaches led to different results. The difference in bias approach is recommended for criteria relating to medical requirements and performance characteristics of measuring systems in use.
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Affiliation(s)
- Chenbin Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology and Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Mingting Peng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology and Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Dongsheng Xu
- Department of Hematopathology, CBLPath/Sonic Healthcare, Rye Brook, NY, USA
| | - Hong Lu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China
| | - Wenbin Zhou
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, P.R. China
| | - Yanhong Liu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology and Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Xiuli Liu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology and Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wenxiang Chen
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology and Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
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Braga F, Panteghini M. Commutability of reference and control materials: an essential factor for assuring the quality of measurements in Laboratory Medicine. ACTA ACUST UNITED AC 2019; 57:967-973. [DOI: 10.1515/cclm-2019-0154] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 02/25/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Traceability to a common reference ensures equivalence of results obtained by different assays. Traceability is achieved by an unbroken sequence of calibrations, using reference materials (RMs) that must be commutable. Using non-commutable RMs for calibration will introduce a bias in the calibrated method producing incorrect results for clinical samples (CS). Commutability was defined in 1973 as “the ability of an enzyme material to show inter-assay activity changes comparable to those of the same enzyme in human serum” and later extended as a characteristic of all RMs. However, the concept is still poorly understood and appreciated. Commutability assessment has been covered in CLSI guidelines and requires: (a) selection of 20 CS spanning the relevant concentration range; (b) analysis of both RM and CS with the pair of procedures; (c) data elaboration using regression analysis and calculation if RM fall within the 95% prediction interval defined by CS. This approach has been criticized and to improve it The International Federation of Clinical Chemistry and Laboratory Medicine established a working group that recently finalized recommendations. Commutability is also a requirement for the applicability of external quality assessment (EQA) results in the evaluation of the performance of participating laboratories in terms of standardization of their measurements. Unfortunately, EQA materials are usually not validated for commutability.
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Affiliation(s)
- Federica Braga
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan , Via G.B. Grassi 74 , Milano , Italy , Phone: +39 02 39042766
| | - Mauro Panteghini
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan , Milano , Italy
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