Professional Documents
Culture Documents
EQAS
EQAS
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External Quality Assurance /Assessment
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Internal QC
• For CONTINUOUS & IMMEDIATE i.e DAILY
monitoring of results
• Whether the patient results are reliable enough to be released
to physicians (WHO, 1981)
• A measure of Repeatability or Reproducibility of the systems
& methods in use in the lab. - Measures Analytical
Imprecision &
• Measures Random Error
• Does not detect the accuracy of patient results over a ‘ longer
term ’
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What is EQA or PT ?
• Each laboratory measures the EQA/ PT samples in singlicate or
duplicate as if they were patient samples and submits results to
the results to the EQA/PT provider for evaluation.
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NEVER DO THESE …
• Ask a specific tech to run the EQA / PT sample
• Repeat the EQA samples and give the mean of multiple values or
the best value
• Discuss EQA results with others &
• Use PT samples for other purposes before submission date
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• A Statistical tool –
• A score given to the lab by the EQAS / PT provider
on the performance of the lab for each analyte in a
EQAS cycle
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Table – 1
Table – 2
WHAT IS SDI ?
IS KNOWING SDI USEFUL ?
• “ The number of Standard Deviations your lab’s value lies
from the Peer Group Mean” – At what SD of peer group is
your lab value ?
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• Any test whose average SDI is 1.0 – 2.0 deserves some special
attention because your method shows a systematic difference from
the group. – potential to lead to unacceptable results in future
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Calculation of VIS
Calculated from % bias / % variation of lab result from DV
= 5.3
Variance Index = %V X 100 = 5.3 X 100 = 76
DCV 7.0
VIS = 76
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Glucose 7% Sodium 3%
Urea 10 % Potassium 4%
Creatinine 9% Chloride 5%
CK 7.3 AST 12.5 %
Bilirubin Total 15% ALT 15 %
Protein Total 6% ALP 15 %
Albumin 6% Amylase 15 %
Calcium 6% Magnesium 7.5 %
Uric acid 7.7 % Phosphorus 7.8 %
Cholesterol 7.5 % Bicarbonate 9.0 %
TGL 12% HDL- C 8%
HDL 7.6 Iron 15 %
CK 7.3%
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Bias % :
Inaccuracy in lab’s result
for the analyte expressed in
as a percentage
& calculated using DV
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BIAS %
75.8-71.8 x 100 = 5.3%
75.8
% bias (% inaccuracy)
• Percentage measure of inaccuracy in your lab’s results
compared to the method group or DV
• Lower the % bias more accurate is your lab method
• Designated Value - 75.8
• Your Lab’s Value - 71.8
• % Bias - 100 x 4 = 5.3%
75.8
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Interpretation of VIS
VIS Performance
< 50 Excellent
50 - 100 Very good
100 -150 Good
150 -200 Satisfactory room for improvement
200 Not acceptable
400 & more Stop testing and set right the problem
before starting again
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• Easily identified – values are far beyond the usual – e.g SDI from
1.5 in earlier cycles to an SDI of 4.0 to 6.0
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• Lab might have changed the method or instrument recently but not
updated with PT provider
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• Wrong units. Result in one unit in the instrument but not converted
to unit of EQA provider e.g ug /mL instead of ng/L , mg/dL instead
of g/L
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PT evaluation Problems
Comparison with Inapt. Peer group
Very narrow range due to small SD of peer mean
Incorrect data entry by PT provider
No explanation
Random error – single / occasional PT is unacceptable esp
when repeat analysis is OK
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