1
|
Bais R, Vassault A, Blasutig IM, Dabla PK, Lin J, Perret-Liaudet A, Thomas A, Cendejas KA, Wheeler SE, Giannoli JM, Meng QH, Amann EP. External quality assessment performance in ten countries: an IFCC global laboratory quality project. Clin Chem Lab Med 2024:cclm-2024-0859. [PMID: 39238208 DOI: 10.1515/cclm-2024-0859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024]
Abstract
OBJECTIVES This study aimed to assess the validity of external quality assessment (EQA) laboratory results across various cultural and environmental contexts and to identify potential improvement areas. METHODS The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on Global Laboratory Quality (TF-GLQ) conducted a 2-year study (2022 and 2023) in which EQA materials, related software and online training was provided by a commercial vendor to 100 laboratories in ten IFCC member society countries. The results were analysed on a monthly basis by the TF-GLQ, to show the number of submissions per country, tests per lab, acceptability rates, random failures and to get a measure of which analytes performed poorly. RESULTS The EQA material was dispatched on a quarterly basis. Some countries had problems with customs releasing the material in a timely manner, resulting in laboratories not receiving them on time leading to no submission. We report here the results for the second year of the survey. The number of examinations varied between laboratories, ranging from seven to 84 analytes. Of the ten countries surveyed, six averaged greater than 90 % acceptable results over the whole 12-months cycle, one had unacceptable results for two of the nine months they returned results and the other four were considered to not perform to an acceptable standard. CONCLUSIONS All 100 participating laboratories indicated satisfaction with the EQA survey and related services, including on-site training, and report handling. However, specimen receiving issues, suggest benefits in dispatching materials for a full 12-month cycle. Significant discrepancies in EQA performance indicate that four countries require long-term assistance, training and guidance. To ensure reliable patient results, promoting EQA in certain countries is essential to achieve the required level of quality.
Collapse
Affiliation(s)
| | | | - Ivan M Blasutig
- Department of Pathology and Laboratory Medicine, Division of Biochemistry, Children's Hospital of Eastern Ontario, Eastern Ontario Regional Laboratory Association, University of Ottawa, Ottawa, ON, Canada
| | - Pradeep Kumar Dabla
- Department of Biochemistry, G. B Pant Institute of Postgraduate Medical Education & Research, Associated Maulana Azad Medical College, New Delhi, India
| | - Ji Lin
- AQR, Abbott Labs, Abbott Park, IL, USA
| | | | - Annette Thomas
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | | | - Sarah E Wheeler
- School of Medicine, Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Qing H Meng
- Director of Clinical Chemistry and Special Chemistry Laboratories, Director of Postdoctoral Clinical Chemistry Fellowship Program, and MD Anderson Cancer Center, Department of Laboratory Medicine, The University of Texas, Houston, TX, USA
| | - Egon P Amann
- Philipps University Marburg, Marburg, Germany
- University of Applied Sciences, Hamm-Lippstadt, Hamm, Germany
- Consultant in Life Sciences, Quality Systems & Clinical Chemistry, Am Martsacker 3, Marburg, Germany
| |
Collapse
|
2
|
Buchta C, Gidske G, Henriksen GM, Badrick T. The European Organisation of External Quality Assurance Providers in Laboratory Medicine (EQALM) Statement: guidelines for publishing about interlaboratory comparison studies (PubILC). Crit Rev Clin Lab Sci 2024:1-11. [PMID: 38572824 DOI: 10.1080/10408363.2024.2335202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
Data and results from interlaboratory comparison (ILC) studies, external quality assessment (EQA) and proficiency testing (PT) activities are important and valuable contributions both to the further development of all disciplines of medical laboratory diagnostics, and to the evaluation and comparison of in vitro diagnostic assays. So far, however, there are no recommendations as to which essential items should be addressed in publications on interlaboratory comparisons. The European Organization of External Quality Assurance Providers in Laboratory Medicine (EQALM) recognized the need for such recommendations, and these were developed by a group of experts. The result of this endeavor is the EQALM Statement on items recommended to be addressed in publications on interlaboratory comparison activities (PubILC), in conjunction with a user-friendly checklist. Once adopted by authors and journals, the EQALM Statement will ensure essential information and/or study-related facts are included within publications on EQA/PT activities.
Collapse
Affiliation(s)
- Christoph Buchta
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria
| | - Gro Gidske
- The Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Gitte M Henriksen
- Danish Institute for External Quality Assurance for Laboratories in the Health Sector (DEKS), Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Tony Badrick
- Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP), St Leonards, NSW, Australia
| |
Collapse
|
3
|
Luppa PB, Zeller M, Pieper M, Kaiser P, Weiss N, Vierbaum L, Freckmann G. Quality assessment of glucose measurement with regard to epidemiology and clinical management of diabetes mellitus in Germany. Front Mol Biosci 2024; 11:1371426. [PMID: 38572446 PMCID: PMC10987728 DOI: 10.3389/fmolb.2024.1371426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Abstract
Background During the last decade, Germany has seen an increased prevalence and a redistribution from undetected to diagnosed diabetes mellitus. Due to this substantial epidemiological development, the number of people with documented type 2 diabetes was 8.7 million in 2022. An estimated two million undiagnosed subjects are to be added. Beyond that, the life expectancy of diabetic subjects is increasing due to more responsive health systems in terms of care. Possible reasons include improved screening of at-risk individuals, the introduction of HbA1c for diagnosis in 2010, and the higher use of risk scores. Additionally, quality aspects of the laboratory methodology should be taken into consideration. Methods Epidemiology and clinical management of diabetes in Germany are presented in the light of publications retrieved by a selective search of the PubMed database. Additionally, the data from German external quality assessment (EQA) surveys for the measurands glucose in plasma and HbA1c in whole blood, reviewed from 2010 until 2022, were evaluated. Above this, data concerning the analytical performance of near-patient glucometer devices, according to the ISO norm 15197:2013, were analyzed. Results Two laboratory aspects are in good accordance with the observation of an increase in the diabetes mellitus prevalence when retrospectively reviewing the period 2010 to 2022: First, the analytical performance according to the ISO norm 15197:2013 of the glucometer devices widely used by patients with diabetes for the glucose self-testing, has improved during this period. Secondly, concerning the EQA program of INSTAND, the number of participating laboratories raised significantly in Germany. The spreads of variations of the specified results for plasma glucose remained unchanged between 2010 and 2022, whereas for HbA1c a significant decrease of the result scattering could be observed. Conclusion These retrospectively established findings testify to an excellent analytical quality of laboratory diagnostics for glucose and HbA1c throughout Germany which may be involved in a better diagnosis and therapy of previously undetected diabetes mellitus.
Collapse
Affiliation(s)
- Peter B. Luppa
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der Technische Universität München, Munich, Germany
| | - Michael Zeller
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der Technische Universität München, Munich, Germany
| | - Marija Pieper
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar der Technische Universität München, Munich, Germany
| | - Patricia Kaiser
- INSTAND e.V., Gesellschaft zur Förderung der Qualitätssicherung in Medizinischen Laboratorien e.V., Düsseldorf, Germany
| | - Nathalie Weiss
- INSTAND e.V., Gesellschaft zur Förderung der Qualitätssicherung in Medizinischen Laboratorien e.V., Düsseldorf, Germany
| | - Laura Vierbaum
- INSTAND e.V., Gesellschaft zur Förderung der Qualitätssicherung in Medizinischen Laboratorien e.V., Düsseldorf, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| |
Collapse
|
4
|
Song XD, Li SX, Qin ZM, Chen DL, Guo LL, Liu CR, Yang X, Peng KN, Dai EH. Ensure the accuracy and consistency of biochemical analyzer test results: Chemometrics for instrument and inter-instrument item comparison in Chinese hospital laboratory. Heliyon 2024; 10:e24306. [PMID: 38268603 PMCID: PMC10806288 DOI: 10.1016/j.heliyon.2024.e24306] [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: 11/21/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
Biochemical analyzers are vital instruments that utilize the principle of photoelectric colorimetry to quantify a specific chemical composition in body fluids. This analysis provides critical data for the diagnosis, treatment, prognosis, and overall health status of various diseases in clinical practice. However, the performance of a biochemical analyzer can vary significantly between different brands or over time within the same brand. Therefore, it is imperative to regularly assess the performance of the analyzer to ensure consistent results for longitudinal studies and to maintain day-to-day data consistency. Additionally, when multiple analyzers are utilized, it is necessary to evaluate the performance of each instrument to ensure accurate results across multiple platforms. In this study, we developed and verified an experimental evaluation scheme for the analytical performance of the instrument, chemometrics for biochemical analyzers, utilizing national reference materials and patient sera as the experimental subjects. We evaluated the performance of the optical system, temperature control system, sample-adding system, and detection system to confirm the feasibility of this scheme. We also compared the analytical performance of different brands of biochemical analyzers for routine biochemical tests, such as liver function, kidney function, ion, blood lipids, blood glucose, and myocardial enzyme spectrum. Using the AU 5400 as a control and the ADVIA 2400 as the comparison system, the relative variation in inter-instrument comparison data was found to be acceptable at the clinical medicine decision level. In conclusion, the performance of a biochemical analyzer can vary significantly between different brands or over time within the same brand. Regular evaluations are necessary to ensure accurate and consistent results across different analyzers. This study provides a feasible scheme for evaluating the analytical performance of biochemical analyzers that can be used to ensure the accuracy and consistency of the results of different brands of automatic chemical analyzers in the laboratory.
Collapse
Affiliation(s)
- Xue-Dong Song
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Shou-Xia Li
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Zhi-Mei Qin
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Ding-Li Chen
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Li-Li Guo
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Cai-Ru Liu
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Xiao Yang
- Department of Laboratory Medicine, Handan Central Hospital, Hebei Medical University, Handan, Hebei, 056001, China
| | - Ke-Nan Peng
- Department of Laboratory Medicine, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, 050051, China
| | - Er-Hei Dai
- Department of Laboratory Medicine, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, 050024, China
| |
Collapse
|
5
|
Wheeler SE, Blasutig IM, Dabla PK, Giannoli JM, Vassault A, Lin J, Cendejas KA, Perret-Liaudet A, Bais R, Thomas A, Amann EP, Meng QH. Quality standards and internal quality control practices in medical laboratories: an IFCC global survey of member societies. Clin Chem Lab Med 2023; 61:2094-2101. [PMID: 37327359 DOI: 10.1515/cclm-2023-0492] [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: 05/11/2023] [Accepted: 06/04/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The trueness and precision of clinical laboratory results are ensured through total quality management systems (TQM), which primarily include internal quality control (IQC) practices. However, quality practices vary globally. To understand the current global state of IQC practice and IQC management in relation to TQM the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on Global Laboratory Quality (TF-GLQ) conducted a survey of IFCC member countries on IQC practices and management. METHODS The survey included 16 questions regarding IQC and laboratory TQM practices and was distributed to IFCC full and affiliate member countries (n=110). A total of 46 (41.8 %) responses were received from all regions except North America. RESULTS Of the responding countries, 78.3 % (n=36) had legislative regulations or accreditation requirements governing medical laboratory quality standards. However, implementation was not mandatory in 46.7 % (n=21) of responding countries. IQC practices varied considerably with 57.1 % (n=28) of respondents indicating that they run 2 levels of IQC, 66.7 % (n=24) indicating they run IQC every 24 h and 66.7 % (n=28) using assay manufacturer IQC material sources. Only 29.3 % (n=12) of respondents indicated that every medical laboratory in their country has written IQC policies and procedures. By contrast, 97.6 % (n=40) of responding countries indicated they take corrective action and result remediation in the event of IQC failure. CONCLUSIONS The variability in TQM and IQC practices highlights the need for more formal programs and education to standardize and improve TQM in medical laboratories.
Collapse
Affiliation(s)
- Sarah E Wheeler
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- School of Medicine, Department of Pathology, University of Pittsburgh, Pittsburgh, USA
| | - Ivan M Blasutig
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Division of Biochemistry, CHEO, Ottawa, Canada
- Eastern Ontario Regional Laboratory Association, Ottawa, Canada
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Pradeep Kumar Dabla
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Department of Biochemistry, G.B. Pant Institute of Postgraduate Medical Education & Research, Associated Maulana Azad Medical College, New Delhi, India
| | - Jean-Marc Giannoli
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Technical Direction Biogroup and Labac, Lyon, France
| | - Anne Vassault
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- University Paris City, France
| | - Ji Lin
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Core Diagnostics, Abbott Labs, Lake Forest, IL, USA
| | - Kandace A Cendejas
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Bio-Rad Laboratories, Quality Systems, Hercules, CA, USA
| | - Armand Perret-Liaudet
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Department of Biochemistry and Molecular Biology Hospices Civils de Lyon, Lyon, France
| | - Renze Bais
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Rbaisconsulting, Australia
| | - Annette Thomas
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - Egon P Amann
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Philipps University Marburg, Marburg, Germany
- University of Applied Sciences, Hamm-Lippstadt, Hamm, Germany
- Consultant in Life Sciences, Quality Systems & Clinical Chemistry, Marburg, Germany
| | - Qing H Meng
- International Federation of Clinical Chemistry and Laboratory Medicine, Task Force on Global Lab Quality, Milan, Italy
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|