External quality assessment scheme for hemostasis in India

Area of Science:

• Clinical Diagnostics
• Laboratory Medicine
• Hematology

Background:

• External quality assessment schemes (EQAS) are crucial for maintaining laboratory performance standards.
• Laboratories in developing countries often face barriers to EQAS participation, including cost and accessibility.
• Hemostasis testing requires accurate laboratory performance, yet EQAS participation is limited in India.

Purpose of the Study:

• To establish and evaluate a national external quality assessment scheme (EQAS) for hemostasis testing in India.
• To address the challenges of limited EQAS participation in developing countries.
• To improve the quality and reliability of hemostasis test results in Indian laboratories.

Main Methods:

• Initiated a hemostasis EQAS in India in 2000, initially supported by the UK NEQAS.
• Transitioned to a national program in 2003 with the Indian Society of Haematology and Transfusion Medicine.
• Implemented local sample manufacture and result analysis since 2004, offering tests for prothrombin time, activated partial thromboplastin time, and factor assays.

Main Results:

• The Indian hemostasis EQAS grew to include over 100 laboratories.
• Recent surveys show 60-95% of participating laboratories achieved consensus on clotting time assays.
• Factor assays showed consensus in 57-77% of laboratories, indicating areas for improvement.

Conclusions:

• The established national EQAS has successfully identified causes of unacceptable performance in hemostasis testing.
• The program demonstrates the feasibility and benefit of local EQAS implementation in resource-limited settings.
• Future efforts should focus on increasing participation, enhancing result reporting, and providing targeted support to laboratories.