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lJLATING

A STANDARD DEVIATION

leviation [s] is a statistic which quantifies how close numerical values

dues)are in relation to each other. The term precision is often used

eably with standard deviation. Another term, imprecision, is used to express

art numerical values are from each other. Standard deviation is calculated for

ducts from the same data used to calculate the mean. It provides the

an estimate of test consistency at specific concentrations. The repeatability

ay be consistent (low standard deviation, low imprecision) or inconsistent

larddeviation, high imprecision). Inconsistent repeatability may be 'due to the

nvolved or to a malfunction. If it is a malfunction, the laboratory must correct

TI.

ision is especially needed for tests which are repeated regularly on the same

rack treatment or disease progress. For example, a diabetic patient

care situation may have glucose levels run every 2 to 4 hours. In this case, it

It for the glucose test to be precise because lack of precision can cause loss

lbility. If there is a lot of variability in the test performance (high imprecision,

ard deviation), the glucose result at different times may not be true.

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Basic Lessons

Although most calculators and. spreadsheet programs automatically calculate standard

In Laboratory

deviation, it is important to understand the underlying mathematics.

Quality Control

(X1l X2J ...xn) use the formula:

I(xn - X)2

s =

n-1

where: s = standarddeviafion

x = mean(average)of the QC values

I(xn - X)2= the sum of the squaresof differencesbetween

individualQC valuesand the mean

n = the numberof valuesin the data set

To calculate the standard deviation for the normal level of control (Levell) in Table 1,

begin by calculating the mean [x]:

x = 28.7 mmol/L + 7

x = 4.1 mmol/L

s= (4.0- 4.1)2+ (4.1- 4.1)2+(4.0-4.1)2+ (4.2- 4.1)2+ (4.1- 4.1f+ (4.1- 4.1)2+ (4.2-4.1f

6

6

s = ~ 0.04 + 6

s = 0.082 or 0.10 (Rounded)

The standard deviation for one week of testing of the normal potassium control level is

0.082 mmol/L.8 Now that the amount of precision is known, some assumptions can be

made about how well this test is performing.

8This type of standard deviation is called between run standard deviation because the data used to calculate

18 the statistics came from different analytical.runs.

) .

CREATINGA LEVEJY-JENNINGS

CHART

Standard deviation is commonly used for preparing Levey-Jennings (L-J or LJ) charts.

The Levey-Jennings chart is used to graph successive (run-to-run or day-to-day) quality

control values. A chart is created for each test and level of control. The first step is to

calculate decision limits. These limits are :t1S, :t2s and :t3s from the mean. The mean

for the Levell potassium control in Table 1 is 4.1 mmol/L and the standard deviation

is 0.1 mmol/l.11 The:t 1s, :t2s and :t3s quality Gontrollimits are calculated as follows:

4.1 + 0.10)(1) = 4.2

4.1 +(0.10)(2)=4.3

4.1 + (0.10)(3)= 4.4 '

These ranges are used with the mean to construct the Levey-Jennings chart

as shown ,in Figure 3.

LEVEL 1 (Normal Control)

Test: Potassium

' _

. ,,'

.5. 4.1 -f--':;f--- r--- 1

- I I I '

,.L---,l---r---t---t---1"---+--+---~---t I---+--+--+---t MEAN

CD

01 I i

-_u,- ---u:

~

a:

4.0' _m-- --m- --m:

--uu

uml-U_--I ~-I f--'---I I I-U---I i I !- -1s

:,,:,1 2 3

[,::':::::"':::::::.:..:

4 5

r

6 7 8

III.C:::..:::.::

9

Run Number

10 .11 12' 13 14 15 16 17 18 19

The Levey-Jennings chart we have developed can be overlaid onto a bell-shaped curve to

illustrate the overall distribution of quality control values (see Fig. 4 on the following page).

11Rounding of the mean and standard deviation to the nearest tenth is allowable in this example because

potassiUm results are generated and reported to the nearest tenth. The standard deviation of 0.08 mmol/L

is rounded to 0.10 mmol/L - _I:

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