The role of EQA in harmonization in laboratory medicine – a global effort

There are many activities currently being undertaken in the field of laboratory medicine under the broad heading of “harmonization”. These include traceability of results to international reference standards, processes to align results from assays where traceability has not been achieved (analytical harmonization) and international or national clinical guidelines based on studies from many parts of the world. Many of these issues are global in nature, with clinical evidence derived from studies performed in all parts of the world and multinational diagnostic companies providing assays worldwide. As with all aspects of medicine, progress can only be assured where these is evidence of effectiveness of the activities. External Quality Assurance (EQA) programs are designed to meet this need. Currently EQA processes have significant limitations in meeting the global needs of the laboratory medicine community. This paper aims to identify the steps that can be taken to allow current and future EQA programs to provide information on global variation in results. It is only by being aware of result differences that steps can be taken to improve performance.

[1]  Bernhard Maassen,et al.  In vitro Diagnostic Medical Devices , 1994 .

[2]  L. Van Nevel,et al.  The International Measurement Evaluation Programme (IMEP): , 1998 .

[3]  [Directive 98/79/CE on in vitro diagnostic medical devices]. , 2002, Annales de biologie clinique.

[4]  Y. Jang,et al.  Standards of Medical Care in Diabetes-2010 by the American Diabetes Association: Prevention and Management of Cardiovascular Disease , 2010 .

[5]  W Greg Miller,et al.  Why commutability matters. , 2006, Clinical chemistry.

[6]  Mauro Panteghini,et al.  Traceability, reference systems and result comparability. , 2007, The Clinical biochemist. Reviews.

[7]  Graham R.D. Jones,et al.  Reporting units for therapeutic drug monitoring: a correctable source of potential clinical error , 2007, The Medical journal of Australia.

[8]  Ilenia Infusino,et al.  Standardization in Clinical Enzymology , 2009, EJIFCC.

[9]  Cas Weykamp,et al.  Proficiency testing/external quality assessment: current challenges and future directions. , 2011, Clinical chemistry.

[10]  Aleš Fajgelj,et al.  Metrological traceability of measurement results in chemistry: Concepts and implementation (IUPAC Technical Report) , 2011 .

[11]  David M Bunk,et al.  Roadmap for harmonization of clinical laboratory measurement procedures. , 2011, Clinical chemistry.

[12]  Mario Plebani,et al.  Harmonization in laboratory medicine: the complete picture , 2013, Clinical chemistry and laboratory medicine.

[13]  Mauro Panteghini,et al.  Verification of in vitro medical diagnostics (IVD) metrological traceability: responsibilities and strategies. , 2014, Clinica chimica acta; international journal of clinical chemistry.

[14]  S. Koetsier,et al.  RCPAQAP First Combined Measurement and Reference Interval Survey. , 2014, The Clinical biochemist. Reviews.

[15]  Graham Ross Dallas Jones Analytical performance specifications for EQA schemes – need for harmonisation , 2015, Clinical chemistry and laboratory medicine.

[16]  Sverre Sandberg,et al.  Defining analytical performance specifications: Consensus Statement from the 1st Strategic Conference of the European Federation of Clinical Chemistry and Laboratory Medicine , 2015, Clinical chemistry and laboratory medicine.

[17]  Graham R D Jones,et al.  The Joint Committee for Traceability in Laboratory Medicine (JCTLM) - its history and operation. , 2016, Clinica chimica acta; international journal of clinical chemistry.

[18]  T. Badrick,et al.  Safe reading of chemical pathology reports: the RCPAQAP Report Assessment Survey. , 2016, Pathology.

[19]  Sverre Sandberg,et al.  The Importance of Reagent Lot Registration in External Quality Assurance/Proficiency Testing Schemes. , 2016, Clinical chemistry.

[20]  W. Herman,et al.  Treatment of Type 1 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes , 2017, Annals of Internal Medicine.

[21]  Ana Paula Faria,et al.  Analytical performance of 17 general chemistry analytes across countries and across manufacturers in the INPUtS project of EQA organizers in Italy, the Netherlands, Portugal, United Kingdom and Spain , 2017, Clinical chemistry and laboratory medicine.