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Solsvik AE, Kristoffersen AH, Sandberg S, Gidske G, Stavelin AV, Eikeland J, Amundsen E. A national surveillance program for evaluating new reagent lots in medical laboratories. Clin Chem Lab Med 2022; 60:351-360. [DOI: 10.1515/cclm-2021-1262] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Objectives
Differences between laboratory results attributable to the use of different reagent lots can potentially affect the diagnosis and monitoring of patients. To minimize patient risks, all laboratories should verify that new reagent lots meet agreed analytical performance specifications (APS). We propose a simplified, pragmatic approach for laboratories that involves compilating results into a national surveillance program, and present the first results obtained when applying this approach to troponins, glycated hemoglobin (HbA1c), prostate-specific antigen (PSA) and D-dimer.
Methods
In the surveillance program we have (i) determined APS for selected analytes, (ii) implemented a simplified procedure for lot evaluation with patient samples used in laboratories across Norway and (iii) performed central processing of the results from the participating laboratories.
Results
Over a one-year period, 27 Norwegian laboratories returned results from 28 lot changes for troponin I, 11 for troponin T, and 29 for HbA1c, PSA and D-dimer. The mean difference between two reagent lots was 4.5% for troponin I (for a concentration interval of 20–32 ng/L), 5.1% for troponin T (10.7–17.5 ng/L), 2.2% for HbA1c (40–50 mmol/mol), 3.7% for PSA (3–5 μg/L) and 5.5% for D-dimer (0.4–1.0 mg/L FEU).
Conclusions
A novel procedure for reagent lot evaluation is proposed in which information about multiple lot changes from different medical laboratories can be accumulated nationally. Sharing this information allows simplification of lot evaluations in individual laboratories and provides real-world data about lot-to-lot variations.
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Affiliation(s)
- Anne Elisabeth Solsvik
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Ann Helen Kristoffersen
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Haukeland University Hospital , Bergen , Norway
| | - Sverre Sandberg
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Haukeland University Hospital , Bergen , Norway
- Department of Global Public Health and Primary Care , Faculty of Medicine, University of Bergen , Bergen , Norway
| | - Gro Gidske
- Department of Medical Biochemistry and Pharmacology , Haukeland University Hospital , Bergen , Norway
- Department of Global Public Health and Primary Care , Faculty of Medicine, University of Bergen , Bergen , Norway
| | - Anne Vegard Stavelin
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Joakim Eikeland
- Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway
| | - Erik Amundsen
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway
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