Klee G G
Division of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Clin Lab Haematol. 1990;12 Suppl 1:65-74.
Performance goals for analytic bias and analytic imprecision are presented for multichannel haematology analysers. These goals represent a compromise between limits that would cause minimal degradation in the information content for clinical decisions and limits that are achievable by current instruments. For midrange measurements the maximal limits for total analytic bias are +/- 14.6% for WBC, +/- 5.3% for RBC, +/- 4.5% for Hb concentration, +/- 4.2% for MCV, and +/- 22% for platelet counts. The limits include error inherent in calibrator value assignment, instrument calibration, instrument drift, and instrument non-linearity as well as the quality control systems necessary to monitor each of these processes. If analytic biases are held within the proposed limits, the clinical specificities of the assays will be decreased by less than 7% for all assays except that platelet counts will have a decrease in specificity of about 15%. Analytic imprecision has minimal direct effect on clinical decisions because the influence of within-person and across-person biological variation dominates. However, analytic imprecision is a major factor in the control of analytic bias and thereby remains an important quality control factor.
本文给出了多通道血液学分析仪分析偏倚和分析不精密度的性能目标。这些目标是在导致临床决策信息含量最小程度降低的限度与当前仪器可达到的限度之间进行折衷的结果。对于中等范围的测量,白细胞(WBC)总分析偏倚的最大限值为±14.6%,红细胞(RBC)为±5.3%,血红蛋白(Hb)浓度为±4.5%,平均红细胞体积(MCV)为±4.2%,血小板计数为±22%。这些限值包括校准物赋值、仪器校准、仪器漂移、仪器非线性以及监测上述每个过程所需的质量控制系统中固有的误差。如果分析偏倚保持在所建议的限值内,除血小板计数特异性将降低约15%外,所有检测项目的临床特异性降低均小于7%。分析不精密度对临床决策的直接影响极小,因为个体内和个体间生物学变异的影响占主导。然而,分析不精密度是控制分析偏倚的主要因素,因此仍然是一个重要的质量控制因素。