Comparison of different approaches to evaluate External Quality Assessment Data.
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in Clinica Chimica Acta (2012), 413(5-6), 582-6
In EQA programs, Z-scores are used to evaluate laboratory performance. They should indicate poorly performing laboratories, regardless of the presence of outliers. For this, two different types of ... [more ▼]
In EQA programs, Z-scores are used to evaluate laboratory performance. They should indicate poorly performing laboratories, regardless of the presence of outliers. For this, two different types of approaches exist. The first type are "outlier-based" approaches, which first exclude outlying values, calculate the average and standard deviation on the remaining data and obtain Z-scores for all values (e.g., Grubbs and Dixon). The second type includes the "robust" approaches (e.g., Tukey and Qn or the algorithm recommended by ISO). The different approaches were assessed by randomly generated samples from the Normal and Student t distributions. Part of the sample data were contaminated with outliers. The number of false and true outliers was recorded and subsequently, Positive and Negative Predictive Values were derived. Also, the sampling mean and variability were calculated for location and scale estimators. The various approaches performed similarly for sample sizes above 10 and when outliers were at good distance from the centre. For smaller sample sizes and closer outliers, however, the approaches performed quite differently. Tukey's method was characterised by a high true and a high false outlier rate, while the ISO and Qn approaches demonstrated weak performance. Grubbs test yielded overall the best results. [less ▲]Detailed reference viewed: 22 (1 ULg)
A new statistical method for evaluating long-term analytical performance of laboratories applied to an external quality assessment scheme for flow cytometry.
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in Clinical Chemistry & Laboratory Medicine (2010), 48(5), 645-50
BACKGROUND: The Belgian External Quality Assessment Scheme for Flow Cytometry evaluates the long-term analytical performance of participating laboratories by calculating a regression line between the ... [more ▼]
BACKGROUND: The Belgian External Quality Assessment Scheme for Flow Cytometry evaluates the long-term analytical performance of participating laboratories by calculating a regression line between the target and reported values of each parameter for each laboratory during the past 3 years. This study aims to develop a method to find laboratories with aberrant variability or bias using robust techniques and to obtain robust estimates of the variability. METHODS: A method is proposed to find outliers with respect to the individual regression line, followed by a step to find regression lines with excessive variability and finally a step to find regression lines with high bias. RESULTS: The model was applied to the results obtained by 52 laboratories for CD4%. From the 1340 data points, 35 were determined to be regression outliers. The second step revealed one regression line with excessive variability; the third step detected three regression lines with exceeding bias. CONCLUSIONS: The methodology allows assessment of the long-term performance of laboratories, taking into account samples with different target values. Outliers in the first step indicate accidental mistakes, outliers in the second and third step point to high analytical variability or bias. [less ▲]Detailed reference viewed: 23 (0 ULg)
Current practices in antinuclear antibody testing: results from the Belgian External Quality Assessment Scheme.
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in Clinical Chemistry & Laboratory Medicine (2009), 47(1), 102-8
BACKGROUND: This study aimed to assess the state-of-the-art of antinuclear antibody (ANA) testing as practiced in the Belgian and Luxembourg laboratories, using the results obtained in the Belgian ... [more ▼]
BACKGROUND: This study aimed to assess the state-of-the-art of antinuclear antibody (ANA) testing as practiced in the Belgian and Luxembourg laboratories, using the results obtained in the Belgian National External Quality Assessment Scheme from 2000 to 2005. METHODS: During this period, nine samples with different specificities were sent for analysis. Participants were surveyed for methodology used and were asked to report staining pattern and titer of ANAs. In 2002, an attempt was made to improve the comparability of quantitative ANA results by the provision of a commercial reference material and to relate observed differences to methodology. RESULTS: With one exception, all participants employed a microscope-based indirect immunofluorescence assay with human epithelial cell line 2 cells. Most laboratories were accurate in describing the pattern. The percentage of unacceptable answers was greater for samples with borderline levels of antibody and for samples showing a cytoplasmic pattern. An improvement in the detection of anticentromere antibodies was observed. For all samples, a wide range of titers was reported. The provision of the secondary reference preparation led to improved inter-laboratory concordance. Comparison of methodology variables revealed a correlation between unstandardized titers and the power of the lamp of the microscope and the use of a dark room. CONCLUSIONS: The EQAS results presented in this work provide valuable insights into the state of the art of ANA testing as practiced in the Belgian and Luxembourg Laboratories and illustrate the important value of a national EQAS for ANA testing as a tool to improve performance and interlaboratory comparability of laboratory results. [less ▲]Detailed reference viewed: 27 (1 ULg)