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Licensed Unlicensed Requires Authentication Published by De Gruyter August 29, 2022

Practical application of European biological variation combined with Westgard Sigma Rules in internal quality control

  • Zhenzhen Song , Jiajia Zhang , Bing Liu , Hao Wang , Lijun Bi and Qingxia Xu EMAIL logo

Abstract

Objectives

Westgard Sigma Rules is a statistical tool available for quality control. Biological variation (BV) can be used to set analytical performance specifications (APS). The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) regularly updates BV data. However, few studies have used robust BV data to determine quality goals and design a quality control strategy for tumor markers. The aim of this study was to derive APS for tumor markers from EFLM BV data and apply Westgard Sigma Rules to establish internal quality control (IQC) rules.

Methods

Precision was calculated from IQC data, and bias was obtained from the relative deviation of the External quality assurance scheme (EQAS) group mean values and laboratory-measured values. Total allowable error (TEa) was derived using EFLM BV data. After calculating sigma metrics, the IQC strategy for each tumor marker was determined according to Westgard Sigma Rules.

Results

Sigma metrics achieved for each analyte varied with the level of TEa. Most of these tumor markers except neuron-specific enolase reached 3σ or better based on TEamin. With TEades and TEaopt set as the quality goals, almost all analytes had sigma values below 3. Set TEamin as quality goal, each analyte matched IQC muti rules and numbers of control measurements according to sigma values.

Conclusions

Quality goals from the EFLM BV database and Westgard Sigma Rules can be used to develop IQC strategy for tumor markers.


Corresponding author: Prof. Qingxia Xu, Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, P. R. China; and Zhengzhou Key Laboratory of Digestive System Tumor Marker Diagnosis, Zhengzhou, Henan, P. R. China, Phone: +86037165587060, E-mail:

Funding source: Health Commission of Henan Province http://dx.doi.org/10.13039/100018925

Award Identifier / Grant number: LHGJ20200202

  1. Research funding: This study was supported by Health Commission of Henan Province, grant number: LHGJ20200202.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2022-04-05
Accepted: 2022-08-17
Published Online: 2022-08-29
Published in Print: 2022-10-26

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