Repeat patient testing-quality control compared to commercial quality control material for the Sysmex XT-2000iV hematology analyzer in a multi-site veterinary laboratory

IF 1.2 4区农林科学 Q3 VETERINARY SCIENCES

Veterinary clinical pathology Pub Date : 2024-02-14 DOI:10.1111/vcp.13332

S. Daly, M. Rishniw, P. A. Graham, K. P. Freeman

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引用次数: 0

Abstract

Background

Quality control material (QCM) for hematology in veterinary laboratories is limited, and repeat patient testing quality control (RPT-QC) is an alternative method using excess matrix-specific samples.

Objectives

This study aimed to determine if median differences between RPT-QC analyses for each time interval for RBC, HGB, HCT, and WBC were the same, determine if unified RPT-QC limits can be applied to a network of veterinary laboratories, compare the performance of RPT-QC to commercial QCM for the reference analyzer and evaluate the experience over a 4 month period and design, improve and implement an automated spreadsheet for RPT-QC data management.

Methods

The potential to unify individual analyzer RPT-QC limits for red blood cells (RBC), hematocrit (HCT), hemoglobin (HGB), and white blood cells (WBC) on multi-site Sysmex XT-2000-iV analyzers was explored by a difference of means test and confidence interval determination for the median difference for each network analyzer in comparison to the network reference analyzer. User experience of an automated RPT-QC data management Excel spreadsheet was collected by user feedback during monthly meetings. Numbers of out-of-control results and the root causes for these for RPT-QC were compared against those of a commercial QCM over a 4-month period.

Results

Differences between individual analyzer RPT-QC limits were too large to allow for unification of network limits. The automated spreadsheet successfully highlighted out-of-control events for RPT-QC. Trends or shifts were more frequent for commercial QCM based on observed performance and a 1–2.5 s QC rule than for RPT-QC. Following routine troubleshooting, RPT-QC out-of-control events were resolved with an alternative RPT-QC sample indicating random error associated with excessive deterioration. Use of an automated spreadsheet for recording RPT-QC, documentation and troubleshooting of out-of-control events, and collating monthly summary calculations were considered an asset in laboratory quality management.

Conclusions

RPT-QC can be successfully implemented and integrated into a multi-site veterinary laboratory. Individual analyzer RPT-QC limit generation is recommended. The deterioration of commercial QCM caused shifts or trends in QC results, which initiated more repeat analyses and investigations than did RPT-QC.

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在一个多站点兽医实验室中，对 Sysmex XT-2000iV 血液分析仪进行病人重复检测--质量控制与商业质量控制材料进行比较。

背景：兽医实验室血液学质控材料（QCM）有限，而重复患者检测质控（RPT-QC）是使用过量特定基质样本的替代方法：本研究旨在确定 RBC、HGB、HCT 和 WBC 每个时间间隔的 RPT-QC 分析之间的中位数差异是否相同，确定统一的 RPT-QC 限值是否可应用于兽医实验室网络，比较 RPT-QC 与商用 QCM 的参比分析仪性能，评估 4 个月的经验，以及设计、改进和实施用于 RPT-QC 数据管理的自动化电子表格：方法：通过均值差异检验和确定每个网络分析仪与网络参考分析仪的中位差异置信区间，探讨了统一多站点 Sysmex XT-2000-iV 分析仪上各个分析仪的红细胞 (RBC)、血细胞比容 (HCT)、血红蛋白 (HGB) 和白细胞 (WBC) 的 RPT-QC 限值的可能性。在月度会议期间，通过用户反馈收集了自动 RPT-QC 数据管理 Excel 电子表格的用户体验。将 4 个月内 RPT-QC 与商用 QCM 的失控结果数量及其根本原因进行了比较：结果：各个分析仪的 RPT-QC 限值差异太大，无法统一网络限值。自动电子表格成功强调了 RPT-QC 的失控事件。与 RPT-QC 相比，基于观察性能和 1-2.5 秒 QC 规则的商用 QCM 更经常出现趋势或变化。常规故障排除后，RPT-QC 失控事件可通过替代 RPT-QC 样品来解决，这表明随机误差与过度劣化有关。使用自动电子表格记录 RPT-QC、记录失控事件并排除故障，以及整理月度汇总计算结果，被认为是实验室质量管理的一项资产：结论：RPT-QC 可以成功实施并整合到多站点兽医实验室中。建议生成单个分析仪的 RPT-QC 限值。与 RPT-QC 相比，商业 QCM 的恶化会导致 QC 结果的变化或趋势，从而引发更多的重复分析和调查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Veterinary clinical pathology 农林科学-兽医学

CiteScore

1.70

自引率

16.70%

发文量

133

审稿时长

18-36 weeks

期刊介绍： Veterinary Clinical Pathology is the official journal of the American Society for Veterinary Clinical Pathology (ASVCP) and the European Society of Veterinary Clinical Pathology (ESVCP). The journal''s mission is to provide an international forum for communication and discussion of scientific investigations and new developments that advance the art and science of laboratory diagnosis in animals. Veterinary Clinical Pathology welcomes original experimental research and clinical contributions involving domestic, laboratory, avian, and wildlife species in the areas of hematology, hemostasis, immunopathology, clinical chemistry, cytopathology, surgical pathology, toxicology, endocrinology, laboratory and analytical techniques, instrumentation, quality assurance, and clinical pathology education.