Clinical Laboratory, The Fifth People's Hospital of Panyu, Guangzhou, China.
J Clin Lab Anal. 2022 Apr;36(4):e24320. doi: 10.1002/jcla.24320. Epub 2022 Mar 7.
To establish an applicable and highly sensitive patient-based real-time quality control (PBRTQC) program based on a data model constructed with patients' results of a procalcitonin point-of-care testing (POCT) analyzer.
Patients' results were retrospectively collected within one year. The Excel software was used to establish quality control (QC) programs of the moving average (MA) and the moving rate of positive results (MR). A Monte Carlo simulation was used to introduce positive and negative biases between 0.01 and 1 ng/ml at random points of the testing data set. Different parameters were used to detect the biases, and the detection efficiency was expressed using the median number of patient samples affected until error detection (MNPed). After comparing the MNPeds of different programs, MA and MR programs with appropriate parameters were selected, and validation plots were generated using MNPeds and maximum number of the patient samples affected (MAX). β curves were generated using the power function of the programs, the performances were compared with that of the conventional QC program.
Neither the conventional QC nor MA program was sensitive to small bias, While MR program can detect the minimum positive bias of 0.06 ng/ml and negative of 0.4 ng/ml at an average daily run size of 10 specimens, with FRs < 1.0%, βs < 1%.
The MR program, which is more sensitive to small biases than conventional QC and MA programs, with low FR and β. As such, it can be used as a PBRTQC program with high performance.
建立一种适用于基于患者即时质量控制(PBRTQC)的方案,该方案基于降钙素原即时检测(POCT)分析仪患者检测结果的数据模型。
回顾性收集一年内患者的结果。使用 Excel 软件建立移动平均(MA)和阳性结果移动率(MR)的质量控制(QC)方案。使用蒙特卡罗模拟在检测数据集的随机点引入 0.01-1ng/ml 的正负偏差。使用不同的参数来检测偏差,并用中位数受影响的患者样本数(MNPed)表示检测效率。比较不同方案的 MNPeds 后,选择合适参数的 MA 和 MR 方案,并使用 MNPed 和受影响的最大患者样本数(MAX)生成验证图。使用程序的幂函数生成β曲线,比较与常规 QC 程序的性能。
常规 QC 或 MA 方案均不能检测小偏差,而 MR 方案在平均每天运行 10 个标本时,可以检测到最小的阳性偏差 0.06ng/ml 和阴性偏差 0.4ng/ml,FR<1.0%,β<1%。
MR 方案比常规 QC 和 MA 方案更能检测到小偏差,具有低 FR 和β,因此可以作为一种具有高性能的基于患者的即时质量控制方案。