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Proficiency testing for blood-gas quality control

C J Delaney, E T Leary, V A Raisys

    Clinical Chemistry
    |October 1, 1976
    PubMed
    Summary
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    A voluntary blood-gas proficiency testing program improved analyzer accuracy and precision across multiple labs. This initiative helps identify issues and establish realistic patient-care protocols for blood-gas analysis.

    Area of Science:

    • Clinical Chemistry
    • Medical Diagnostics
    • Laboratory Medicine

    Background:

    • Blood-gas analysis is critical for patient diagnosis and management.
    • Variability in blood-gas analyzer performance can impact clinical decisions.
    • Existing quality control programs may not detect all sources of analytical error.

    Purpose of the Study:

    • To assess the effectiveness of a community blood-gas proficiency testing program.
    • To evaluate the initial accuracy and precision of blood-gas analyzers in participating laboratories.
    • To monitor improvements in analyzer performance over time.

    Main Methods:

    • A voluntary proficiency testing program was implemented for 32 blood-gas analyzers in 16 laboratories.
    • Tonometered human blood was used as the testing material.

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  • Data on analyzer accuracy (po(2), pco(2)) and precision (CV) were collected and analyzed over a 15-week period.

    • Main Results:

    • Initial inaccuracies ranged from -30.8% to +17.3% for po(2) and -14.0% to +42.9% for pco(2).
    • Inaccuracy and imprecision decreased significantly in most laboratories during the program.
    • Mean group precision (CV) achieved was 4.3–5.1% for po(2) and 4.0–6.9% for pco(2).

    Conclusions:

    • Proficiency testing effectively detects analyzer deterioration, interlaboratory bias, and issues missed by routine quality control.
    • The program empowers participants to improve data quality discussions with clinicians and justify instrument maintenance.
    • Documenting blood-gas analysis variability aids in establishing realistic patient-care protocols.