[Present status and problems of external quality assurance program of Japan Medical Association].

The external quality assurance (EQA) program of the Japan Medical Association was started in 1967. This program had just 70 laboratory institutes of 15 examination items in 1967 and has 2917 laboratory institutes of 47 items in 2004. This program is thought to be the most reliable EQA program in Japan and is used as marker for the evaluation of laboratory institutes. Each laboratory institute gets marks according to the basis of common coefficient of variation (CV) of each examination item. This program has the following problems: (1) examination items (urine tests and bacteriological tests are not performed), (2) number of programs in a year, (3) examination sample (matrix of the examination sample is similar to the native sample), and (4) valuation basis (valuation basis is getting strict and some laboratories may have cheated the program). This program has to change by improving these issues.