Home About us Contact
|
Home About us Contact | ||
|
|
||
External Quality Assessment (external + quality_assessment)
Terms modified by External Quality Assessment Selected AbstractsQuality assurance for oral anticoagulation self management: a cluster randomized trialJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 3 2008E. T. MURRAY Summary.,Background and aims:,External quality assessment (EQA) should be an inherent component of patient self management (PSM) of oral anticoagulation. The aim of this study was to evaluate methods of EQA for patients within a cluster randomized trial. Method:,After development of methods, general practises were randomly allocated to a formal EQA scheme of patients performing the test independently at home or at their practise with supervision. The supervised group of practises was further sub divided to test two other EQA methods: (i) venous sample compared with patients' point of care (POC) device; and (ii) patients POC compared with reference POC. Primary trial outcome measure was reliability of results from the formal scheme taking into account adherence and test errors. Results:,Proportion of EQA scheme tests in range was 633/836 (75.7%). Proportion in range was significantly higher in group performing independently compared with supervised group, 80.1% vs. 71.5% respectively, P = 0.02. Sixty-six percent of tests were in range with venous compared with patients POC, and 88% in patients POC compared with reference POC. Conclusion:,Patients are able to undertake a formal EQA scheme and perform more reliably at home independently. There are satisfactory alternatives if a formal scheme is not acceptable. [source] External quality assessment of rapid prenatal detection of numerical chromosomal aberrations using molecular genetic techniques: 3 years experiencePRENATAL DIAGNOSIS, Issue 5 2007S. C. Ramsden Abstract Objectives Prenatal diagnosis using rapid molecular genetic techniques is now a widely used method for detecting the most prevalent chromosomal aneuploidies. The object of this work was to develop a methodology for delivering external quality assessment (EQA) appropriate to the needs of routine diagnostic testing laboratories. Methods We have provided three rounds of EQA using 15 different samples over 3 years. The scheme has developed to assess both the genotyping accuracy of the results and the appropriateness of the clinical reports issued to the referring clinician. Results Participation in the EQA scheme has increased from 9 to 27 laboratories from across Europe over the three sample distributions. All laboratories have used quantitative fluorescence-PCR (QF-PCR) to analyse these samples except for a sole participant in 2006 who used multiplex ligation-dependent probe amplification (MLPA). In total 265 samples have been distributed, of which four (1.5%) were not reported due to technical failures and one (0.4%) was reported incorrectly and must be regarded as a genotyping error. Conclusions We have demonstrated a significant and increasing demand for EQA in the rapid detection of aneuploidies in UK and other European laboratories. Using the methodologies described, we have had a very low rate of technical failures and demonstrated a high level of genotyping accuracy. However, the quality of the clinical reports was variable and suggestions are made for improvement. Copyright © 2007 John Wiley & Sons, Ltd. [source] Evaluation and use of a synthetic quality control material, included in the European external quality assessment scheme for cystic fibrosis,HUMAN MUTATION, Issue 8 2008Sarah Berwouts Abstract Assuring high quality within the field of genetic testing is fundamental, as the results can have considerable impact on the patient and his or her family. The use of appropriate quality control (QC) samples is therefore essential. Diagnostic laboratories mainly use patient samples as QC material, which of course include a maximum of two mutations per sample. Bearing in mind that some assays (such as for cystic fibrosis [CF] testing) can test for more than 100 mutations, multiplex QC materials including more than two mutations could save valuable time and reagents. Based on this need, synthetic multiplex controls have been developed by Maine Molecular Quality Controls, Inc. (MMQCI) for CF. A synthetic control, containing six homozygous mutations and one polymorphism for CF transmembrane conductance regulator (CFTR), was evaluated by distributing it through the CF external quality assessment (EQA) scheme, along with the EQA samples in 2005. A total of 197 participants returned results of the yearly EQA scheme and 133 laboratories participated in the evaluation of the synthetic sample. Respectively, 76% and 73% of the participants were assigned as successful. This evaluation study revealed that the multiplex QC material performed well in the majority of assays and could be useful in method validation, as a tool to challenge interpretation skills, and as potential proficiency testing (PT) material. Hum Mutat 0, 1,8, 2008. © 2008 Wiley-Liss, Inc. [source] Measuring the perceived impact of facilitation on implementing recommendations from external assessment: lessons from the Dutch visitatie programme for medical specialistsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2005M. J. M. H. (Kiki) Lombarts PhD Abstract Objective, To evaluate the impact of facilitation by management consultants on implementing recommendations from external quality assessment (visitatie). Design, Data collection through a postal survey amongst 205 medical specialists, representing 50 hospital-based specialist groups in, the ,Netherlands., Setting, Under the auspices of the specialty societies of surgeons, paediatricians and gynaecologists, 25 groups were offered ,20 h of management consulting to support the implementation of recommendations for quality improvement and were compared to 25 specialist groups not receiving the support. Intervention, The Quality Consultation (QC) took a site-specific multifaceted implementation approach. Main measures, Self-reported degree of implementation of recommendations, specialists' judgement of implementation result and process; experienced obstructing factors in implementing recommendations. Results, The response rate was 54% (n = 110). The supported specialist groups were more successful in partially or fully implementing the recommendations from external peer assessment: 66.1% vs. 53.8%. The implementation result and process were also rated significantly higher for the supported groups. The supported groups reported significantly less (P < 0.005) obstructing factors; in particular for the barriers ,expectation of implementation advantages', ,acceptance of the recommendations' and ,assessed self-efficacy'. The experienced obstructing factors are strongly related with the degree of implementation (spearman rho 0.57,32.5%). Conclusions, This study suggests QC is a powerful implementation strategy. It also shows the limitations of merely quantitatively analysing multifaceted strategies: it does not offer any insight into the ,black box' of the QC. It is recommended that these limitations are met by also exploring multifaceted strategies qualitatively. [source] External quality assessment of rapid prenatal detection of numerical chromosomal aberrations using molecular genetic techniques: 3 years experiencePRENATAL DIAGNOSIS, Issue 5 2007S. C. Ramsden Abstract Objectives Prenatal diagnosis using rapid molecular genetic techniques is now a widely used method for detecting the most prevalent chromosomal aneuploidies. The object of this work was to develop a methodology for delivering external quality assessment (EQA) appropriate to the needs of routine diagnostic testing laboratories. Methods We have provided three rounds of EQA using 15 different samples over 3 years. The scheme has developed to assess both the genotyping accuracy of the results and the appropriateness of the clinical reports issued to the referring clinician. Results Participation in the EQA scheme has increased from 9 to 27 laboratories from across Europe over the three sample distributions. All laboratories have used quantitative fluorescence-PCR (QF-PCR) to analyse these samples except for a sole participant in 2006 who used multiplex ligation-dependent probe amplification (MLPA). In total 265 samples have been distributed, of which four (1.5%) were not reported due to technical failures and one (0.4%) was reported incorrectly and must be regarded as a genotyping error. Conclusions We have demonstrated a significant and increasing demand for EQA in the rapid detection of aneuploidies in UK and other European laboratories. Using the methodologies described, we have had a very low rate of technical failures and demonstrated a high level of genotyping accuracy. However, the quality of the clinical reports was variable and suggestions are made for improvement. Copyright © 2007 John Wiley & Sons, Ltd. [source] Organisation of proficiency testing for plant health diagnostic tests: the experience of FAPAS®EPPO BULLETIN, Issue 1 2010A. Reynolds Proficiency testing (PT) is an established quality assurance measure and is based on the comparison of laboratories' results in an inter-laboratory trial. It highlights problems in laboratory analysis and is an educational tool to help improve data quality. This article describes how PT is organised by FAPAS®. FAPAS® is an international PT provider (external quality assessments) for food chemistry, food microbiology, genetically modified material and water/environmental samples. Since 2007, FAPAS® have organized plant health proficiency tests in conjunction with the Plant Pest and Disease Identification Programme at the Food and Environment Research Agency (Fera). Up until 2009, FAPAS® has organised seven plant health proficiency tests that covered the identification of lyophilised bacteria, viruses in leaves and fungi in agar plugs. In 2009, FAPAS® organized over 10 plant health proficiency tests under the banner of ,PhytoPAS', including Potato spindle tuber viroid, Phytophthora ramorum, Thrips palmi, Erwinia amylovora, Clavibacter michiganensis subsp. sepedonicus, etc. DNA extracts, cyst nematodes (Globodera pallida) and slides/immunofluorescence (IF) slides have been added to the programme. The organization of the plant health proficiency tests follows a similar pattern. Suitable test materials are prepared and tested for quality before distribution to requesting participants. Laboratories usually have 1,2 months to analyze their samples and return their results. A report is then compiled for issue to laboratories and these contain all results in an anonymous form, so that laboratories can compare their results with those of other participants. If a laboratory's performance is unsatisfactory then it is up to them to investigate the situation. Thus, the primary purpose of PT is the detection of inaccuracy in a laboratory's results, so that they can investigate the problems and initiate corrective procedures. [source] Repeated HIV-1 resistance genotyping external quality assessments improve virology laboratory performance,JOURNAL OF MEDICAL VIROLOGY, Issue 2 2006Diane Descamps Abstract The performance of French virology laboratories belonging to the ANRS network has been assessed annually for 3 years. The performance of these laboratories was compared between the years 2002 and 2003. Ten and 7 coded samples were sent to 38 virology laboratories in 2002 and 45 virology laboratories in 2003, respectively. Each panel of coded samples included at least one HIV-negative control, a pair of duplicate specimens, samples with a wide range of viral loads, and samples with a large number of resistance mutations. The laboratories used their standard sequencing procedures and were asked to report the amino acids at codons associated with resistance mutations, based on the IAS-USA expert panel list. The reference amino acid sequences were defined as those most frequently reported by the participants. The specificity of detection of RT mutations was significantly better in 2003 (99.9%) than in 2002 (99.7%) (P,=,0.05). There was no difference between 2002 and 2003 in the specificity of detection of protease mutations (99.6% and 99.8%) or the sensitivity of detection of RT mutations (98.8% and 98.2%). The sensitivity of detection of protease mutations improved significantly between 2002 and 2003 (97.6% and 99.0%, respectively; P,=,0.037). The proportion of laboratories reporting fully accurate results, in terms of amplification, specificity, sensitivity, and reproducibility, tended to increase between 2002 and 2003 (P,=,0.077). No errors were made by 19% of laboratories in 2002, compared to 42% in 2003. These results show the value of repeated external quality assessments. J. Med. Virol. 78:153,160, 2006. © 2005 Wiley-Liss, Inc. [source] | |||||||||||||