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Quality of plasma cholesterol measurements in primary care
P M Broughton1, D G Bullock, R Cramb
1Department of Clinical Chemistry, Queen Elizabeth Medical Centre, Birmingham.
Insights
Quality control for plasma cholesterol measurements using the BCL Reflotron analyser in primary care revealed issues. Many users need better training and support to improve accuracy and reduce errors in cholesterol testing.
Area of Science:
- Clinical Chemistry
- Point-of-Care Testing
- Quality Assurance in Healthcare
Background:
- Plasma cholesterol measurement is crucial for cardiovascular risk assessment in primary care.
- Commercial desktop analysers like the BCL Reflotron are widely used outside traditional laboratory settings.
- Ensuring the accuracy and reliability of these point-of-care tests is essential for patient management.
Purpose of the Study:
- To assess the quality of plasma cholesterol measurements using the BCL Reflotron analyser in primary care settings.
- To identify common sources of error affecting measurement accuracy.
- To provide recommendations for improving the quality of cholesterol testing outside hospital laboratories.
Main Methods:
- Three quality surveys were conducted involving participants using the BCL Reflotron analyser.
- Each survey utilized three distinct specimens for analysis.
- Results from 37, 61, and 69 participants were collected and analyzed.
Main Results:
- While many participants achieved satisfactory results, 8.6% showed deviations of 1.0 mmol/l or more from target values.
- The between-instrument dispersion of results was 1.3 times higher than that observed in hospital laboratories.
- Poor user technique and the use of outdated reagent strips were identified as significant sources of error.
Conclusions:
- Users of desktop analysers like the BCL Reflotron require enhanced training and support.
- Establishing collaborations with local clinical chemistry laboratories is recommended for training and quality assessment.
- Participation in external quality assessment schemes is vital for maintaining accurate cholesterol measurements.
Abstract:
Three surveys were made of the quality of plasma cholesterol measurements performed with a commercial desktop analyser (BCL Reflotron) in primary care. Each survey included three specimens, and results were received from 37, 61, and 69 participants. Although many participants obtained satisfactory results, 8.6% of the results differed by 1.0 mmol/l or more from the target values, and the overall between instrument dispersion of results was 1.3 times that between hospital laboratories. It was found that common sources of error were poor technique and the use of outdated reagent strips. Users of such instruments outside the laboratory need help and advice with training, and guidelines for this are provided. The main recommendations are that users should establish contact with a local clinical chemistry laboratory for training and support and should participate in external quality assessment schemes.