Abstract

IntroductionMoving average (MA) is one possible way to use patient results for analytical quality control in medical laboratories. The aims of this study were to: (1) implement previously optimized MA procedures for 10 clinical chemistry analytes into the laboratory information system (LIS); (2) monitor their performance as a real-time quality control tool, and (3) define an algorithm for MA alarm management in a small-volume laboratory to suit the specific laboratory.Materials and methodsMoving average alarms were monitored and analysed over a period of 6 months on all patient results (total of 73,059) obtained for 10 clinical chemistry parameters. The optimal MA procedures were selected previously using an already described technique called the bias detection simulation method, considering the ability of bias detection the size of total allowable error as the key parameter for optimization.ResultsDuring 6 months, 17 MA alarms were registered, which is 0.023% of the total number of generated MA values. In 65% of cases, their cause was of pre-analytical origin, in 12% of analytical origin, and in 23% the cause was not found. The highest alarm rate was determined on sodium (0.10%), and the lowest on calcium and chloride.ConclusionsThis paper showed that even in a small-volume laboratory, previously optimized MA procedures could be successfully implemented in the LIS and used for continuous quality control. Review of patient results, re-analysis of samples from the stable period, analysis of internal quality control samples and assessment of the analyser malfunctions and maintenance log have been proposed for the algorithm for managing MA alarms.

Highlights

  • Moving average (MA) is one possible way to use patient results for analytical quality control in medical laboratories

  • This paper showed that even in a small-volume laboratory, previously optimized MA procedures could be successfully implemented in the laboratory information system (LIS) and used for continuous quality control

  • Re-analysis of samples from the stable period, analysis of internal quality control samples and assessment of the analyser malfunctions and maintenance log have been proposed for the algorithm for managing MA alarms

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Summary

Introduction

Moving average (MA) is one possible way to use patient results for analytical quality control in medical laboratories. Internal quality control is a critical segment of medical laboratory practice It is based on analysing commercially available control materials at specific time intervals [1]. The results of these measurements are compared with known target values and standard deviations, following well-established guidelines and recommendations [2]. This type of control is adequately supported by modern automated analysers and information systems. The scientific community is aware that this traditional type of quality control has its weaknesses [3] These are, first of all, its intermittency, and the problem of commutability [4].

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