Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Edmonton, Alberta, Canada.
Clin Biochem. 2021 Nov;97:62-66. doi: 10.1016/j.clinbiochem.2021.07.017. Epub 2021 Jul 31.
Reagent lot-to-lot comparisons are recommended by accreditation bodies to ensure that the performance of each reagent lot meets acceptable standards for quality patient results. The general approach is comprised of performing quality control (QC) and patient comparison between the old and new reagent lots and evaluating against a pre-defined criteria. Reagent lot comparison practices are often variable despite using the same instrument across different laboratories. This is costly, time consuming, and can lead to variability in acceptance criteria. While Clinical & Laboratory Standards Institute (CLSI) has a recommended guideline for reagent lot validation, it is often difficult to execute for small and rural laboratories due to limited resources. Defining the analytes required for detailed validation is important to allocate appropriate resources to ensure quality patient results. The goal of this study was to develop a standardized approach to reagent lot validation and optimize lab resources on Vitros chemistry instruments.
This study consists of a retrospective and prospective analysis of reagent lot changes in dry slide chemistry analyzers (Ortho Clinical Diagnostics Vitros). Two years of retrospective reagent lot comparison data was obtained at a single site. A prospective study was conducted by assessing aliquots of 10 patient sample pools at 9 sites with Vitros analyzers.
Of the 19 chemistry analytes evaluated, albumin, sodium, and total protein showed significant differences between reagent lots and also exceeded the pre-defined acceptance criteria.
For these analytes, our recommendations are to perform a comprehensive lot validation with QC and patient samples. A simple lot validation with a reflex approach comprised of initially assaying QC can be adapted for the more stable analytes to allow achieving quality patient result in a resource constraint rural environment.
认证机构建议进行试剂批次间比较,以确保每个试剂批次的性能符合质量患者结果的可接受标准。一般方法包括在新旧试剂批次之间进行质量控制(QC)和患者比较,并根据预先定义的标准进行评估。尽管在不同的实验室中使用相同的仪器,但试剂批次比较的做法往往存在差异。这既昂贵又耗时,并且可能导致验收标准的差异。虽然临床和实验室标准协会(CLSI)有试剂批次验证的推荐指南,但由于资源有限,对于小型和农村实验室来说,通常难以执行。定义详细验证所需的分析物对于分配适当的资源以确保质量患者结果很重要。本研究的目的是开发一种标准化的试剂批次验证方法,并优化 Vitros 化学仪器上的实验室资源。
本研究包括对干片化学分析仪(Ortho Clinical Diagnostics Vitros)中试剂批次变化的回顾性和前瞻性分析。在一个地点获得了两年的回顾性试剂批次比较数据。通过在 9 个具有 Vitros 分析仪的地点评估 10 个患者样本池的等分试样进行了前瞻性研究。
在所评估的 19 种化学分析物中,白蛋白、钠和总蛋白在试剂批次之间存在显著差异,并且超过了预先定义的验收标准。
对于这些分析物,我们的建议是使用 QC 和患者样本进行全面的批次验证。对于更稳定的分析物,可以采用包含最初检测 QC 的反射方法进行简单的批次验证,以允许在资源有限的农村环境中实现质量患者结果。