Zhang Shishi, Wang Wei, Zhao Haijian, He Falin, Zhong Kun, Yuan Shuai, Wang Zhiguo
National Center for Clinical Laboratories/Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Clin Lab Anal. 2018 Jan;32(1). doi: 10.1002/jcla.22154. Epub 2017 Feb 15.
Internal quality control (IQC) plays a key role in the evaluation of precision performance in clinical laboratories. This report aims to present precision status of thyroid hormones immunoassays from 2011 to 2016 in China.
Through Clinet-EQA reporting system, IQC information of Triiodothyronine and Thyroxine in the form of free and total (FT3, TT3, FT4, TT4), as well as Thyroid Stimulating Hormone (TSH) were collected from participant laboratories submitting IQC data in February, 2011-2016. For each analyte, current CVs were compared among different years and measurement systems. Percentages of laboratories meeting five allowable imprecision specifications (pass rates) were also calculated. Analysis of IQC practice was conducted to constitute a complete report.
Current CVs were decreasing significantly but pass rates increasing only for FT3 during 6 years. FT3, TT3, FT4, and TT4 had the highest pass rates comparing with 1/3TEa imprecision specification but TSH had this comparing with minimum imprecision specification derived from biological variation. Constituent ratios of four mainstream measurement systems changed insignificantly. In 2016, precision performance of Abbott and Roche systems were better than Beckman and Siemens systems for all analytes except FT3 had Siemens also better than Beckman. Analysis of IQC practice demonstrated wide variation and great progress in aspects of IQC rules and control frequency.
With change of IQC practice, only FT3 had precision performance improved in 6 years. However, precision status of five analytes in China was still unsatisfying. Ongoing investigation and improvement of IQC have yet to be achieved.
室内质量控制(IQC)在临床实验室的精密度性能评估中起着关键作用。本报告旨在呈现2011年至2016年中国甲状腺激素免疫测定的精密度状况。
通过Clinet-EQA报告系统,收集了2011年2月至2016年提交IQC数据的参与实验室中三碘甲状腺原氨酸和甲状腺素的游离及总形式(FT3、TT3、FT4、TT4)以及促甲状腺激素(TSH)的IQC信息。对于每种分析物,比较了不同年份和测量系统的当前变异系数(CV)。还计算了符合五个允许不精密度规范的实验室百分比(通过率)。对IQC实践进行分析以形成完整报告。
6年间当前CV显著下降,但仅FT3的通过率有所上升。与1/3TEa不精密度规范相比,FT3、TT3、FT4和TT4的通过率最高,但TSH与源自生物学变异的最小不精密度规范相比通过率最高。四种主流测量系统的构成比变化不显著。2016年,除FT3外,雅培和罗氏系统对所有分析物的精密度性能均优于贝克曼和西门子系统,FT3的西门子系统也优于贝克曼系统。IQC实践分析表明,在IQC规则和控制频率方面存在广泛差异且取得了很大进展。
随着IQC实践的变化,6年间只有FT3的精密度性能有所提高。然而,中国五种分析物的精密度状况仍不尽人意。IQC的持续调查和改进仍有待实现。