Quality of clinical information: a new approach of EQA in Emilia-Romagna, Italy

For correct enforcement of an external quality assessment (EQA) scheme, suitable parameters are required for the assessment of analytical performance. Traditional EQA schemes have always been chiefly concerned with the agreement of analytical results between laboratories. Although we consider this concept to be important, we also believe that particular attention must be paid to the quality of the clinical information, in relation to correct use of the results. On the basis of this principle, we have developed an EQA model which, besides considering the absolute value, also take the reference limits (RLs) into consideration by means of the normalization procedure. The evaluation of clinical information is of vital importance, especially in relation to immunoassays, since the low degree of standardization between methods, and the ensuing phenomenon of relative inaccuracy, make the use of suitable RLs essential. Actually, analysis of the results reveals a high degree of heterogeneity in the RLs used by the laboratories, even within the same method-groups.