A new optimization combination used in the exponentially weighted moving average quality control of electrolyte programs

IF 3.2 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Clinica Chimica Acta Pub Date : 2025-04-01 DOI:10.1016/j.cca.2025.120280

Mindong Mi , Jiyong Gong , Weijie Sun , Tunguang Xu , Qifeng Jiang , Danqing Zhang , Axiang Han , Wei Liang

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引用次数: 0

Abstract

Objective

This study aimed to optimize and validate the EWMA QC procedure for potassium (K), sodium (Na), and chloride (Cl) by selecting optimal exponential weighting factors (λ), quality control limits (CLs), and truncation limits (TLs).

Methods

Data from 150,000 serum tests for K, Na, and Cl were obtained from the Laboratory Medicine Department of the First Affiliated Hospital of Ningbo University. The dataset included inpatient, outpatient, and physical examination populations. Using testing times, 400 simulated days with 375 tests each were created. The EWMA QC process was optimized and verified across the three analytes using false positive rate (FPR), true positive rate (TPR), and the median number of patient results affected before error detection (MNped).

Result

The EWMA QC procedure with λ = 0.2 outperformed other λ values for Na and Cl, achieving higher sensitivity for errors exceeding the total allowable error (TEa) and better performance with λ = 0.5 for errors below 1/2TEa in K. All three programs maintained FPRs below 5 %. The optimal QC (λ = 0.2) detected 99.93 % of Na errors and 86.30 % of Cl errors. However, K’s QC showed lower sensitivity, with poor performance even at 2TEa.

Conclusion

The EWMA QC method demonstrated high sensitivity and specificity for Na and Cl programs with an optimal λ of 0.2. However, its performance for K was suboptimal, indicating limited applicability in this analyte.

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用于电解质程序指数加权移动平均质量控制的新优化组合

目的通过选择最佳指数加权因子（λ）、质量控制限（CLs）和截断限（TLs），对钾(K)、钠（Na）和氯（Cl）的EWMA质量控制程序进行优化和验证。方法收集宁波大学第一附属医院检验内科15万份血清K、Na、Cl检测资料。数据集包括住院、门诊和体检人群。使用测试时间，创建了400个模拟日，每个模拟日包含375个测试。通过假阳性率（FPR）、真阳性率（TPR）和错误检测前受影响的患者结果中位数（MNped），对三种分析物的EWMA QC流程进行了优化和验证。结果λ = 0.2的EWMA QC程序对Na和Cl的λ值优于其他程序，对超过总允许误差（TEa）的误差具有更高的灵敏度，对k中小于1/2TEa的误差具有更好的灵敏度，三种程序的fpr均保持在5%以下。最优QC （λ = 0.2）的Na误差检出率为99.93%，Cl误差检出率为86.30%。然而，K的QC灵敏度较低，即使在2TEa时也表现不佳。结论EWMA质量控制方法对Na和Cl程序具有较高的灵敏度和特异性，最佳λ为0.2。然而，它对K的性能不是最优的，表明在该分析物中的适用性有限。

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

Clinica Chimica Acta 医学-医学实验技术

CiteScore

10.10

自引率

2.00%

发文量

1268

审稿时长

23 days

期刊介绍： The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells. The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.