scholarly journals Data connectivity: A critical tool for external quality assessment

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Ben Cheng ◽  
Brad Cunningham ◽  
Debrah I. Boeras ◽  
Patron Mafaune ◽  
Raiva Simbi ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Disease Surveillance ◽  
External Quality Assessment ◽  
Point Of Care ◽  
External Quality ◽  
Central Database ◽  
Operational Metrics ◽  
Real Time Information ◽  
Time Information

Point-of-care (POC) tests have been useful in increasing access to testing and treatment monitoring for HIV. Decentralising testing from laboratories to hundreds of sites around a country presents tremendous challenges in training and quality assurance. In order to address these concerns, companies are now either embedding connectivity in their new POC diagnostic instruments or providing some form of channel for electronic result exchange. These will allow automated key performance and operational metrics from devices in the field to a central database. Setting up connectivity between these POC devices and a central database at the Ministries of Health will allow automated data transmission, creating an opportunity for real- time information on diagnostic instrument performance as well as the competency of the operator through external quality assessment. A pilot programme in Zimbabwe shows that connectivity has significantly improve the turn-around time of external quality assessment result submissions and allow corrective actions to be provided in a timely manner. Furthermore, by linking the data to existing supply chain management software, stock-outs can be minimised. As countries are looking forward to achieving the 90-90-90 targets for HIV, such innovative technologies can automate disease surveillance, improve the quality of testing and strengthen the efficiency of health systems.

scholarly journals Accuracy of HbA1c as Monitored by External Quality Assessment and Compared With Patient Mean Values

2018 ◽  
Vol 12 (4) ◽  
pp. 771-779 ◽  
Author(s):  
Gunnar Nordin
Keyword(s):  
Quality Assessment ◽  
External Quality Assessment ◽  
Point Of Care ◽  
Small Variation ◽  
Specific Method ◽  
External Quality ◽  
Swedish Population ◽  
Mean Values ◽  
Hba1c Test ◽  
Performance Specifications

Background: The accuracy and trueness of results from a laboratory test, such as the HbA1c test, should not be taken for granted but must be checked continuously. A tool for this is the participation in external quality assessment (EQA) for all laboratories performing the HbA1c-test. An additional possibility to detect changes in trueness is to monitor variations in patient cohort mean or median values that is not explained by changes in treatment or selection of patients. Methods: Results reported to an EQA scheme for HbA1c during 20 years have been extracted from Equalis database. The results are compared to current analytical performance specifications (APS) and to the mean HbA1c levels for the Swedish population of persons with type 2 diabetes. Results: The accuracy of the HbA1c test has improved during the period. The hospital lab methods used in Sweden now fulfil APS agreed by professional organizations in Sweden. The accuracy for point-of-care tests (POCT) methods vary over time and fulfil APS for some periods. The bias found for some of the methods might explain changes seen in patient mean values for HbA1c in Sweden during the period 2007-2017. Conclusions: The global standardization of HbA1c has resulted in an improved comparability for HbA1c-results worldwide. But even small variation in trueness for the methods in use might have important impact on mean HbA1c values for cohorts of patients. When a systematic error is observed for a specific method it is therefore essential that manufacturers correct the method without delay.

Assessing quality on the Sigma scale from proficiency testing and external quality assessment surveys

2015 ◽  
Vol 53 (10) ◽  
Author(s):  
James O. Westgard ◽  
Sten A. Westgard
Keyword(s):  
Quality Assessment ◽  
Proficiency Testing ◽  
External Quality Assessment ◽  
Objective Assessment ◽  
Analytical Quality ◽  
External Quality ◽  
Proficiency Assessment ◽  
Laboratory Examinations ◽  
Intended Use

AbstractThere is a need to assess the quality being achieved for laboratory examinations that are being utilized to support evidence-based clinical guidelines. Application of Six Sigma concepts and metrics can provide an objective assessment of the current analytical quality of different examination procedures.A “Sigma Proficiency Assessment Chart” can be constructed for data obtained from proficiency testing and external quality assessment surveys to evaluate the observed imprecision and bias of method subgroups and determine quality on the Sigma scale.Data for hemoglobin AAssessment of quality on the Sigma scale provides evidence of the analytical performance that is being achieved relative to requirements for intended use and should be useful for identifying and prioritizing improvements that are needed in the analytical quality of laboratory examinations. In spite of global and national standardization programs, bias is still a critical limitation of current HbA

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