Virginia Commonwealth University, Richmond, VA.
Jeff Budd Consulting, St. Paul, MN.
Clin Chem. 2020 Jun 1;66(6):769-778. doi: 10.1093/clinchem/hvaa048.
Establishing metrological traceability to an assigned value of a matrix-based certified reference material (CRM) that has been validated to be commutable among available end-user measurement procedures (MPs) is central to producing equivalent results for the measurand in clinical samples (CSs) irrespective of the clinical laboratory MPs used. When a CRM is not commutable with CSs, the bias due to noncommutability will be propagated to the CS results causing incorrect metrological traceability to the CRM and nonequivalent CS results among different MPs. In a commutability assessment, a conclusion that a CRM is commutable or noncommutable for use with a specific MP is made when the difference in bias between the CRM and CSs meets or does not meet a criterion for that specific MP when compared to other MPs. A conclusion regarding commutability or noncommutability requires that the magnitude of the difference in bias observed in the commutability assessment remains unchanged over time. This conclusion requires the CRM to be stable and no substantive changes in the MPs. These conditions should be periodically reverified. If an available CRM is determined to be noncommutable for a specific MP, that CRM can be used in the calibration hierarchy for that MP when an appropriately validated MP-specific correction for the noncommutability bias is included. We describe with examples how a MP-specific correction and its uncertainty can be developed and applied in a calibration hierarchy to achieve metrological traceability of results for CSs to the CRM's assigned value.
建立与经过验证可在现有终端用户测量程序(MP)之间互换的基于矩阵的认证参考材料(CRM)赋值相关联的计量溯源性,对于临床样本(CS)中测定物的结果等效性至关重要,而与使用的临床实验室 MPs 无关。当 CRM 与 CS 不可互换时,由于不可互换性引起的偏倚将传播到 CS 结果中,导致对 CRM 的计量溯源性不正确,并且不同 MPs 之间的 CS 结果不等效。在可互换性评估中,当 CRM 和 CSs 之间的偏倚差异与其他 MPs 相比,符合或不符合特定 MPs 的标准时,就会得出 CRM 可与特定 MP 一起使用或不可与特定 MP 一起使用的结论。关于可互换性或不可互换性的结论要求在可互换性评估中观察到的偏倚差异的幅度随时间保持不变。该结论要求 CRM 稳定,并且 MPs 没有实质性变化。这些条件应定期重新验证。如果确定特定 MP 的可用 CRM 不可互换,则可以在包含非互换性偏倚的适当验证的特定 MP 校正后,将该 CRM 用于该 MP 的校准层次结构中。我们将通过示例描述如何开发和在校准层次结构中应用特定于 MP 的校正及其不确定性,以实现 CS 到 CRM 赋值的结果的计量溯源性。