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Related Experiment Videos

Proficiency testing performance: a case study with modeling.

Jennifer M Waugh1, Christine P Collier, Andrew G Day

  • 1Division of Clinical Laboratories, Kingston General Hosital, Kingston, Ontario K7L 3N6, Canada.

Clinical Biochemistry
|November 5, 2002
PubMed
Summary
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Proficiency testing (PT) analysis reveals that while imprecision is a factor, bias significantly impacts laboratory performance. Addressing bias is crucial for improving PT results and quality improvement efforts in clinical chemistry.

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Quality Assurance

Background:

  • Proficiency testing (PT) is essential for evaluating laboratory performance.
  • Previous studies focused on minimum PT requirements, often defining levels of imprecision and bias.
  • This study assessed current PT performance and modeled quality improvement strategies.

Purpose of the Study:

  • To assess current proficiency testing (PT) performance in a clinical chemistry laboratory.
  • To model different scenarios to prioritize quality improvement efforts.
  • To identify the primary causes of PT failures and suggest improvements.

Main Methods:

  • Retrospective analysis of 1,006 chemistry challenge results from Ontario's Laboratory Proficiency Testing Program (LPTP, now QMPLS) between 1999-2000.

Related Experiment Videos

  • Comparison of results against peer group means, all method means, and reference labs.
  • Modeling to predict flagging rates based on varying imprecision and bias levels.

    • Main Results:

    • Internal imprecision was <5% for 72% of tests, but only 20% met a CV/PT <25%.
    • 13.5% of results were outside PT limits, with 5.5% flagged and 2.4% requiring clarification.
    • Follow-up revealed nonanalytical errors (38%) and method bias errors (33%) as significant contributors to PT failures.

    Conclusions:

    • Imprecision alone would lead to a 1.6% flagging rate, but strict PT criteria increase this significantly.
    • Judicial review reduced investigations, highlighting the impact of nonanalytical errors.
    • Bias is a major cause of poor PT performance, necessitating action from laboratories and manufacturers, and evolution of PT programs.