Prommetta Simaporn, Sanchaisuriya Kanokwan, Fucharoen Goonnapa, Yamsri Supawadee, Chaiboonroeng Attawut, Fucharoen Supan
Medical Science Program, Graduate School, Khon Kaen University, Thailand.
Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand.
Biochem Med (Zagreb). 2017 Jun 15;27(2):387-397. doi: 10.11613/BM.2017.040.
Thalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results.
Three PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, . mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants' result against the assigned value.
Of all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance.
Improved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided.
东南亚地区已实施地中海贫血筛查项目多年，但尚未建立外部质量评估项目。我们首次在泰国开展并启动了能力验证（PT）项目，旨在评估实验室工作人员的筛查表现及其对筛查结果的解读能力。
每年组织三个PT周期。从PT方案的第一个周期到第三个周期，参与实验室的总数从59个增加到67个。在每个周期中，提供2个PT项目（指定为夫妇的血样）。性能评估基于筛查结果的准确性、平均红细胞体积（MCV）、平均红细胞血红蛋白（MCH）以及血红蛋白E的二氯酚靛酚（DCIP）试验，包括对筛查结果的解读能力和胎儿风险评估。通过将参与者的结果与指定值进行比较来评估性能。
在所有三个周期中，大多数实验室报告的MCV和MCH值均可接受。从第一个周期到第三个周期，DCIP试验错误和错误解读率有所下降，而错误风险评估则因周期而异。综合地中海贫血筛查的准确性以及解读和风险评估能力，约一半的参与者表现出色。
许多实验室观察到的性能提升反映了PT项目的成果和益处，应定期开展该项目。
