Original Article
Application and efficacy of patient-based real-time quality control in intralaboratory comparison of various hematology analyzers
Huang Shanshan, Li Guixia, Huang Hui, Wang Huiru, Wang Shenghua, Bai Xiaomeng, Zhou Shanshan
Published 2023-03-19
Cite as Chin J Lab Med, 2023, 46(3): 310-318. DOI: 10.3760/cma.j.cn114452-20220804-00452
Abstract
ObjectiveTo evaluate the application value of patient-based real-time quality control (PBRTQC) algorithms in intralaboratory comparison between various hematology analyzers.
MethodFrom April 1st 2020 to March 31th 2021, data of white blood cell (WBC) counts and daily comparison results of fresh venous blood, measured by five hematology analyzers, were collected at the Department of Laboratory Medicine in Hebei Children′s Hospital. First, the professional intelligent PBRTQC software system was applied to conduct the parameter setting, program establishment, and performance verification. Three concentration ranges of WBC were selected, low concentration (2.5-4.5)×109/L, medium concentration (6.0-8.0)×109/L and high concentration (12.0-14.0)×109/L for the comparison. Next, WBC counts were calculated with both of the EWMA and median methods, the results were then analyzed by PBRTQC using the module of"intralaboratory comparison of hematology analyzers". Finally, bias of intralaboratory comparison among various hematology analyzers analyzed by means of EWMA and daily comparison results of fresh venous blood were compared. Based on the standard of WS/T 406-2012,allowable error ±7.50% in WBC counts was set as the relative bias standard among different instruments.
Results(1) A total of 38 313 sample results were included, there were 70 warning results out of these samples based on the EWMA quality control method established on the data of patients with white blood cell count in our laboratory, with an early warning rate of 0.183‰, a probability of error detection of 100%, and a probability of false loss of control of 0. EWMA quality control efficiency met the quality objectives. (2) In the comparison monitoring of the results of 5 blood cell analyzers at high concentrations, the coincidence rate between EWMA and median method were both 100% (46/46) in weekly and monthly comparison, and EWMA could maintain a relatively stable monitoring efficiency in daily comparison. (3) In the selected natural month, the consistency rate between EWMA method and fresh blood comparison method was 95.24% (20/21).
ConclusionPBRTQC can be used as a valuable supplementary tool of IQC to continuously and effectively monitor the consistency of data derived from intralaboratory hematology analyzers with different bands and types, which can not only reduce the risk of quality and operating costs, but also improve the efficiency of laboratory management.
Key words:
Blood cell count; Patient-based real-time quality control; Exponentially weighted moving average; Laboratory management
Contributor Information
Huang Shanshan
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Li Guixia
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Huang Hui
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Wang Huiru
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Wang Shenghua
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Bai Xiaomeng
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China
Zhou Shanshan
Department of Clinical Laboratory,Hebei Children′s Hospital, Shijiazhuang 050031, China