Affiliation:
1. Quality Department, Laboratories, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
2. Biochemistry Department, Hospital de la Santa Creu i Sant Pau , IIB Sant Pau , Barcelona , Spain
3. Core Laboratory, Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
4. Centre of Biomedical Investigation Network for Diabetes and Metabolic Diseases (CIBERDEM) , Madrid , Spain
Abstract
Abstract
Objectives
To assess the usefulness of the EP31-A-IR guideline published by the Clinical and Laboratory Standards Institute (CLSI) to perform the periodic verification of results’ comparability between several analyzers.
Methods
Twenty-four biochemistry parameters that could be measured in different analyzers were included: albumin, alkaline phosphatase, alanine aminotransferase, amylase, aspartate aminotransferase, calcium, chloride, C-reactive protein, creatine kinase, creatinine, direct bilirubin, gamma glutamyl transferase, glucose, lactate dehydrogenase, magnesium, phosphate, potassium, sodium, total bilirubin, total cholesterol, total protein, triglycerides, urea and uric acid. In accordance with the EP31-A-IR guideline: (1) Patient samples were selected considering the concentration or activity of interest. (2) Acceptance criteria were established specifically for each concentration or activity level. A quality specification based on biological variation or on state of the art was selected, considering the analytical performance of the available technology. (3) Maximum allowable differences (MAD) between analyzers were calculated. (4) Measurements were performed as stated in appendix B of the guideline. (5) Maximum differences between analyzers were calculated. Results were considered comparable when the maximum difference was less than or equal to the MAD.
Results
For the 24 parameters evaluated, any difference between analyzers exceeded the MAD.
Conclusions
The EP31-A-IR guideline proved to be useful for periodic verification of results’ comparability. However, it must be considered that, to be practicable, it may require to adjust the acceptance criteria in accordance to the analytical performance of the available technology; as well as the number of analytical measurements conforming to the laboratory resources.
Subject
Biochemistry (medical),Clinical Biochemistry,General Medicine
Reference11 articles.
1. Clinical and Laboratory Standards Institute (CLSI). Measurement procedure comparison and bias estimation using patient samples. Approved guideline – CLSI document EP09-A3. Wayne, PA: CLSI; 2013.
2. Braga, F, Panteghini, M. Commutability of reference and control materials: an essential factor for assuring the quality of measurements in Laboratory Medicine. Clin Chem Lab Med 2019;57:967–73. https://doi.org/10.1515/cclm-2019-0154.
3. EN ISO 15189:2022. Medical laboratories – particular requirements for quality and competence. Geneva: ISO; 2022.
4. Clinical and Laboratory Standards Institute (CLSI). Verification of comparability of patient results within one health care system. CLSI document EP31-A-IR. Wayne, PA: CLSI; 2012.
5. Harris, EK. Statistical principles underlying analytic goal-setting in clinical chemistry. Am J Clin Pathol 1979;72:374–82.