see some ref on the Westgard web on this topic:
www.westgard.com/qcapp52.htm
Best wishes, Rita Horvath
Hungary
Frost, Stephen írta:
> Hello
>
> We are reviewing how we maintain agreement with main analysers across sites
> in the Trust and the recent string, reproduced below in part, came to mind.
> Can I ask your advice, if your labs do this, about what procedures you use.
> For example, do you compare patient samples or just compare QCs, and how
> often, do you rely on comparison of QC results electronically, assuming the
> same batch gives the same results, or regularly send an aliquot around the
> sites, and so on? What 'pass' criteria do you use for result agreement?
>
> Are there any guidelines on this?
>
> Regards
> Steve
>
> Ps will summarise if enough replies
>
> ________________________________________________________
>
>
>
> Tel 01444 441881 ext 8197
> Fax 01444 414051
> email [log in to unmask]
>
> Views expressed are my own and not necessarily those of the Trust.
>
>
> -----Original Message-----
> From: David Robertshaw [mailto:[log in to unmask]]
> Sent: 05 August 2008 15:50
> To: [log in to unmask]
> Subject: Re: Cross site EQA
>
> Chris - Does IQC actually "control" anything. It gives you a day to day
> asssment of the quality of an assay which allows Laboratory staff to do
> something to control the quality.
>
> David
>
>
>
>>>> Royle Chris <[log in to unmask]> 04/08/08 17:35:20 >>>
>>>>
> Sorry, have I missed something?. IQA. What's that? I thought that EQA
> (external quality assessment) and IQC (internal quality control, with the
> accent on the word control) were the only terms in use? (nod towards J.
> Middle)
> Apologies if I'm not keeping up. Seems to be happening more and more these
> days.... :-(
>
> Chris
> Chris Royle
> Service Manager,
> Clinical Biochemistry and Haematology Departments,
> Royal Brompton and Harefield NHS Trust,
> Royal Brompton Hospital,
> Sydney Street,
> LONDON
> SW3 6NP
> phone: + 44 (0)20 7351 8413
> fax: + 44 (0)20 7351 8416
> e mail [log in to unmask]
>
> P Save Paper - Do you really need to print this e-mail?
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]] On Behalf Of Hallworth Mike (RLZ)
> Sent: 04 August 2008 17:11
> To: [log in to unmask]
> Subject: Re: Cross site EQA
>
> Hi Janice
>
> I think you've missed David's point. The difference is that lab analysers
> have frequent and rigorous IQA checks which POCT analysers generally don't.
> These are used to ensure that the right results are going out - and to do it
> BEFORE they go out, which is rather better than waiting for the EQA to come
> back, when it is a bit late...
>
> In this situation, EQA is telling you primarily about differences in
> method/analyser bias rather than poor consumables, instrument malfunctions
> etc. And there is a good argument for registering only one analyser for that
> purpose, and using the IQA to monitor differences between analysers (I'm not
> getting into the 'fiddle factor' debate!!).
>
> I think David raises a legitimate point which merits serious discussion, not
> dismissed as you have done.
>
> Mike
>
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]] On Behalf Of Janice Still
> Sent: 04 August 2008 16:55
> To: [log in to unmask]
> Subject: Re: Cross site EQA
>
> David, I can only assume that you have your tongue firmly in your cheek. If
> not, then you have successfully taken my breath away! The analysers may be
> the same, the cartridges and reagents may be the same,but what the USERS do
> to them is certainly not the same.I am also concerned by your mention of
> "tweaking". I thought that we had all abandoned fiddle factors long ago.
> Every single one of my analysers is individually EQA enrolled and I would
> not have it any other way. Recently the EQA showed a sudden negative bias on
> PCO2 on one analyser, which was eventually traced to the sample path not
> being kept at 37C. If I was only looking at EQA on one analyser, how would
> this have been picked up? If you decided to take the lab as your "typical "
> instrument, where it is looked after by qualified BMS staff, what hope
> mwould there be for the instrument in A/E and all the misuse that it
> gets?You simply CANNOT blithely assume that one size fits all. How do you
> know that consumables have been stored correctly, or have been used before
> the sell by date? At the end of the day the whole object of EQA is to ensure
> that the PATIENT gets the right result on the instrument that their blood is
> analysed on. Yes it is expensive. Live with it. And I hope your patients do.
>
> JanMrs. J. Still,
> POCT Manager,
> Biochemistry Dept,
> Watford General Hospital. 01923-217998.
> The views expressed in this message are personal and do not reflect West
> Herts NHS Hospitals Trust policy.
>
>
>
> ----- Original Message ----
> From: David Robertshaw <[log in to unmask]>
> To: [log in to unmask]
> Sent: Monday, 4 August, 2008 2:09:19 PM
> Subject: Cross site EQA
>
> The Leeds/Bradford Biochemistry service has four sites all with the same
> analytical equipment using the same reagents and IQA. IQA performence is
> compared regularly and used to "tweak" the analysers to get the same answers
> across all sites. Why then do we need to enrol all four sites in the same
> EQA scheme?? If one analyser is performing satisfactorily compared to the
> "National norm", (as evidenced by EQA), and the other analysers compare
> satisfactorily with that one why repeat the EQA analysis?? I believe many
> hospitals with several Blood Gas Analysers of the same make will only EQA
> one and accept performnce of the others on the basis of IQA. Could this
> principle not be applied far more widely particularly in the light of
> networking and the fact that equipment, reagent production, cartridge
> manufacture and standards are common across many sites.
>
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