External Quality Assessment in Laboratory Testing
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Questions and Answers

What is the primary purpose of External Quality Assessment (EQA)?

  • To compare laboratory results with international standards
  • To inspect laboratory facilities
  • To challenge participants' quality systems and encourage improvement (correct)
  • To provide training to laboratory staff
  • What is another term for External Quality Assessment (EQA)?

  • Internal Quality Control
  • Proficiency Testing (PT) (correct)
  • Laboratory Accreditation
  • Quality Improvement Program
  • What is one of the benefits of External Quality Assessment (EQA)?

  • It reduces the workload of laboratory staff
  • It provides early warning for systematic problems (correct)
  • It is only required for small laboratories
  • It increases the cost of laboratory operations
  • What is NOT a principle of EQA Schemes?

    <p>To provide incentives for poor performance</p> Signup and view all the answers

    What is the outcome of effective External Quality Assessment (EQA)?

    <p>Physicians, patients, and health authorities are assured of reliable laboratory results</p> Signup and view all the answers

    What type of samples are used in External Quality Assessment (EQA)?

    <p>Blinded samples that closely simulate clinical material</p> Signup and view all the answers

    What happens to the report if all results pass the evaluation?

    <p>It is placed in the department EQA file after discussing with AGM LAB.</p> Signup and view all the answers

    What is the purpose of the CPA meeting?

    <p>To discuss the results with concerned section supervisor/ Manager, AGM LAB and find root cause.</p> Signup and view all the answers

    What is a possible source of analytical problems in EQA?

    <p>Reagents, instruments, test methods, calibrations and calculations</p> Signup and view all the answers

    What can be a source of error in post-examination?

    <p>Clerical or transcription errors</p> Signup and view all the answers

    What happens if any parameter does not pass the evaluation?

    <p>The QA Coordinator initiates CPA.</p> Signup and view all the answers

    What is the purpose of a peer group in EQA?

    <p>To analyze the same specimens using the same brand and model of instruments.</p> Signup and view all the answers

    What can be a problem in pre-examination?

    <p>Improper storage of samples</p> Signup and view all the answers

    Who attends the CPA meeting?

    <p>QA Coordinator, concerned section supervisor/ Manager, AGM LAB</p> Signup and view all the answers

    What does the standard deviation measure in a laboratory test?

    <p>The repeatability of the test at specific concentrations</p> Signup and view all the answers

    Why is good precision important in laboratory tests?

    <p>To track treatment or disease progress in a patient</p> Signup and view all the answers

    What is the coefficient of variation (CV) in laboratory testing?

    <p>The ratio of the standard deviation to the mean</p> Signup and view all the answers

    How is bias measured in laboratory testing?

    <p>By comparing the results to a target value or estimate</p> Signup and view all the answers

    What is the purpose of the mode in laboratory testing?

    <p>To evaluate laboratory performance and identify potential deviations or biases</p> Signup and view all the answers

    What does the mean represent in laboratory testing?

    <p>The average of the results in a laboratory test</p> Signup and view all the answers

    What is the formula to calculate bias in laboratory testing?

    <p>Bias % = Lab Mean - Concensus Group mean * 100</p> Signup and view all the answers

    Why is it important to have repeated measurements of the same specimen in laboratory testing?

    <p>To have results as close to each other as possible</p> Signup and view all the answers

    What is the primary purpose of the mode in EQA?

    <p>To serve as a reference point for evaluating laboratory performance, setting targets, and monitoring trends</p> Signup and view all the answers

    What can be revealed by proper analysis of EQAS testing results?

    <p>Potential problems before failure in EQAS or even an adverse patient result</p> Signup and view all the answers

    How can problems be recognized in EQAS results?

    <p>By comparing results to the target peer group mean</p> Signup and view all the answers

    What type of error is indicated by results consistently being different from the target peer group mean?

    <p>Systematic error</p> Signup and view all the answers

    What type of error is indicated by results showing larger deviations on one side or both sides of the mean?

    <p>Random error</p> Signup and view all the answers

    Why is it important to review both the present cycle results and performance from previous cycles for the same analyte?

    <p>To identify trends and potential problems</p> Signup and view all the answers

    What is an important feature of a good EQA scheme?

    <p>Internationally recognized with many participating laboratories</p> Signup and view all the answers

    What is the benefit of EQA for the patient?

    <p>Knows the system is working together to ensure the public receives accurate and useful information</p> Signup and view all the answers

    What should be done with EQA samples upon receipt?

    <p>Analyze them immediately, if not possible store them appropriately and record the delay</p> Signup and view all the answers

    What is the role of the QA Person in EQA sample processing?

    <p>Receives the samples and hands them over to the concerned department</p> Signup and view all the answers

    What is the purpose of EQA?

    <p>To ensure system confidence and public recognition</p> Signup and view all the answers

    What should be done with leftover EQA samples?

    <p>Keep them till the final report of the sample is received</p> Signup and view all the answers

    What should be done with preparation instructions provided with EQA samples?

    <p>Adhere to them exactly</p> Signup and view all the answers

    What is an important step in the EQA process?

    <p>Analyzing EQA samples in good time</p> Signup and view all the answers

    Study Notes

    External Quality Assessment (EQA)

    • An external quality monitoring scheme that consists of "blinded" samples that closely simulate clinical material
    • A technique to challenge a laboratory's internal QC methods and procedures
    • A program to assess laboratory performance and the ability to determine the "correct" result
    • Also termed Proficiency Testing (PT)

    Importance of EQA

    • Important for improvement
    • A measure of laboratory performance

    Principles of EQA Schemes

    • Challenge participants' quality systems
    • Encourage inter-laboratory comparability
    • Encourage improvement
    • Provide insight into national/international levels of performance
    • Allow poor performance to be addressed
    • Excellent source of reference material
    • Required in licensing (accreditation)

    Quality Improvement

    • Provides early warning for systematic problems associated with kits or operations
    • Provides objective evidence of testing quality
    • Indicates areas that need improvement
    • Identifies training needs
    • Helps to ensure physicians, patients, and health authorities that the laboratory can produce reliable results

    Characteristics of a Good EQA Scheme

    • Internationally recognized
    • Has many participating laboratories
    • Numerous and varied samples
    • Several distributions throughout the year
    • Rapid report turnaround
    • Preferably electronic result entry and report return
    • Friendly and helpful – advice in trouble-shooting
    • Educational

    EQA Process

    • Management Process
      • Choose the right Scheme for your needs
      • Analyze EQA samples in good time
      • Treat EQA samples same as patient samples
      • Monitor and maintain records
      • Investigate deficiencies
      • Manage corrective action efforts
      • Communicate outcomes

    Benefits of EQA

    • The Laboratory
      • System confidence
      • Self-assessment and recognition
      • Public confidence
    • The Patient
      • Knows the system is working together to ensure the public receives accurate and useful information

    EQA Sample Processing

    • Receive and process EQA samples
    • Analyze data and submit to QA Coordinator
    • Enter data in respective accounts provided by the EQA body
    • Keep leftover samples until the final report is received

    EQA Performance Problems

    • Pre-examination
      • Sample may have been compromised during preparation, shipping, or after receipt in the laboratory
      • Sample may have been processed or labeled improperly in the laboratory
    • Examination
      • EQA challenge materials may exhibit a matrix effect in the examination system used by the participating laboratory
      • Analytical problems should be investigated to determine whether error is random or systemic
    • Post-examination
      • Report format can be confusing
      • Interpretation of results can be incorrect
      • Clerical or transcription errors can be sources of error

    Interpretation of EQA Results

    • Mean: The mean for a group of data points is simply the calculated average
    • Coefficient of Variation (CV): The ratio of the standard deviation to the mean
    • Bias: Measures how far your observed value is from a target value
    • Lab.Bias % = Lab Mean - Consensus Group mean *100 / Consensus Group mean

    Mode

    • Evaluate laboratory performance: By comparing a laboratory's results to the mode, EQA providers can assess their performance and identify potential deviations or biases
    • Set target values: The mode can serve as a target value for laboratories to strive for, ensuring that their results are consistent with peer group performance
    • Monitor trends: Tracking changes in the mode over time helps EQA providers detect shifts in laboratory performance or instrument drift
    • Improve quality: By analyzing the mode and associated data, EQA providers can identify areas for improvement and implement measures to enhance laboratory quality

    Why Analysis of EQAS Reports is Important

    • Proper analysis of EQAS testing results can reveal problems even before failure in EQAS or even an adverse patient result
    • Recognizing patterns from graphs
    • Review both the present cycle results as well as performance from previous cycle for the same analyte
    • Graphs of Z score or SD or RMZ or % deviation for trends

    How to Recognize Problems

    • Results may consistently be different from the target peer group mean - All results on one side of the mean (may be close to mean or at variable distances from mean) Systematic Error
    • Majority of results are close to the target value but some show larger deviations on one side or both sides of mean – Random Error
    • Reasons and hence corrective action differs

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    Description

    This quiz covers the concept of External Quality Assessment (EQA) in laboratory testing, including its importance and methods for evaluating laboratory performance.

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