A.

Quality Control and Maintenance of Clinical Chemistry Analyzers

In NEQAS, the NRLs serve as the “role model” for the other laboratories to follow.
The NRLs contain the best protocols, the most advanced equipment, and the most
skillful operators in the country, hence they serve as the example every laboratory must
follow. The NEQAS provides laboratories with insight on how they can further improve
their accuracy and consistency, whether it be through better instrumentation, personnel
skill, or reagents, by having the NRL as the standard. Additionally, by participating in the
NEQAS, you can compare your results with other laboratories across the nation. This
guarantees that quality is maintained across all laboratories and assures patients that
they are getting the best treatment and diagnosis, no matter which part of the country
they come from.
B. Quality Control of Clinical Chemistry Analyzers

a. Mean =
92+70+85+75+ 96+86+ 88+90+111+100+ 85+89+76+ 85+90+98+ 91+100+101+102
=90.5
20
b. Median = 70, 75, 76, 85, 85, 85, 86, 88, 89, 90, 90, 91, 92, 96, 98, 100, 100,
101, 102, 111
c. Mode = 85 (Most frequent data point)
d. Standard Deviation = x̄ = 90.5, n = 20

√ ∑ ( x − x̄ )2 = ( 92−90.5 ) +( 70−90.5 ) +( 85−90.5 ) +( … )+(102−90.5)

n−1 (20)−1
( 92−90.5 ) + ( 70−90.5 ) + ( 85−90.5 ) + ( 75−90.5 )2+ ( 96−90.5 )2 + ( 86−90.5 )2 + ( 88−90.5 )2 + ( 90−90.5 )2 + ( 111−
2 2 2

¿
√ 1923
19
= √ 101.21=10.06
e. Variance = 10.062=101.21

f. Coefficient of Variance = (
10.06
90.5 )
×100=11.12%

g. Values from +3SD up to -3SD

SD1=90.5 ±10.06
SD2=90.5 ±(10.06 ×2)
SD3=90.5 ±(10.06 × 3)

+ SD 3=90.5+ ( 10.06× 3 )=120.68

+ SD 2=90.5+ (10.06 × 2 )=110.62
+ SD 1=90.5+10.06=100.56
−SD1=90.5−10.06=80.44
−SD2=90.5−( 10.06 ×2 )=70.38
−SD3=90.5−( 10.06 ×3 ) =60.32
 h. Acceptable range from 95% confidence limit
Mean = 90.5
N = 20
Degrees of Freedom = 20-1 = 19
Standard Deviation = 10.06
Confidence Limit = 95%
s
Confidence interval= x̄ ± t
√n
From the tables provided online, 19 degrees of freedom is equal to a t-value of
2.093 for two tailed tests.
10.06
90.5 ± 2.09
√20
90.5 ± 2.09 ( 2.25 )
90.5 ± 4.70
90.5+ 4.70=95.2
90.5−4.70=85.8

Thus, the acceptable range is 85.8 to 95.21.

C. Plotting

Rules violated:
 12s (Day 2 and Day 9)
Action: Warning
D. Screening Test Results for Glycomarkblood Test
Rapid Test Results With Diabetes Without Diabetes
Positive 46 (True Positives) 47 (False Positives)
Negative 140 (False Negatives) 967 (True Negatives)

967
1. Specificity = TN/(TN + FP) = =0.95∨95 %
1014
46
2. Sensitivity = TP/(TP + FN) = =0.25∨25 %
186
46
3. Positive Predictive Value = TP/(TP + FN) = =0.25∨25 %
186
967
4. Negative Predictive Value = TN/(TN + FP) = =0.95∨95 %
1014