Analytical Performance Specifications Derived from External Quality Assessment Data: Comparison with Biological Variation-Based Models for Intermediate Precision Assessment.
TL;DR
APSs derived from pooled EQA peer group data provide realistic and technically achievable intermediate precision targets consistent with current AP and thus can complement BV-based specifications.
Abstract
Background Analytical performance specifications (APSs) are essential for quality management in medical laboratories. Considering the discrepancies between laboratory performance and existing guidelines, lack of consideration of concentration-dependent variability, and absence of recommendations for certain parameters, we aimed to define APSs for internal use in biochemistry, hemostasis, and hematology based on external quality assessment (EQA) peer group data and evaluate their suitability for intermediate precision assessment versus biological variation (BV)-based APSs. Methods EQA-based allowable CV (CVallowable) was estimated from pooled CVs derived from EQA peer group results. Allowable bias, expanded measurement uncertainty, and total allowable error were calculated. CVallowable targets were assessed using intermediate precision data from different analytical systems within a laboratory group and compared with BV-based APSs. Concordance between theoretical specifications derived from mathematical models and observed analytical performance (AP) was evaluated using (i) the proportion of internal QC CVs meeting the predefined CVallowable across laboratories and (ii) observed analytical imprecision expressed as a percentage of the allowable imprecision budget. Results APSs were established for 110 biochemical analytes, 23 hemostasis parameters, and 28 hematology parameters across different concentration ranges. EQA-derived APSs agreed with observed intermediate precision for 102 biochemical, 14 hemostasis, and 24 hematology parameters. BV-based APSs showed agreement for only 49 biochemical, two hemostasis, and 11 hematology parameters, while overly restrictive goals or lack of agreement were observed for several analytes. Conclusions APSs derived from pooled EQA peer group data provide realistic and technically achievable intermediate precision targets consistent with current AP and thus can complement BV-based specifications.