QMS, QA, QC Flashcards
Classify if random error or systematic error:
- error in pipetting
- change in incubation period
Random error
Classify if random error or systematic error:
- variation in incubation temperature
- change in reagent batch
- modifications in testing methods
Systematic Error
What is a trend?
Trend indicates a gradual loss of reliability in the test system.
What is a shift?
It is an abrupt change in control mean.
Trend or Shift: Deterioration of instrument light source
Trend
Trend or Shift: Accumulation of debris in sample/reagent tubing
Trend
Trend or Shift: Accumulation of debris on electrode surfaces
Trend
Trend or Shift: Aging of reagents
Trend
Trend or Shift: Deterioration of control materials
Trend
Trend or Shift: Deterioration of incubation chamber temps (enzymes only)
Trend
Trend or Shift: Deterioration of light filter integrity
Trend
Trend or Shift: Calibration deterioration
Trend
Trend or Shift: QC data represents a sudden and dramatic positive or negative change in test system performed
Shift
Trend or Shift: Sudden failure or change in light source
Shift
Trend or Shift: Change in reagent formulation and reagent lot
Shift
Trend or Shift: Major instrument maintenance
Shift
Trend or Shift: Sudden change in incubation temperature (enzyme only)
Shift
Trend or Shift: Room temp or humidity change
Shift
Trend or Shift: Failure in sampling system
Shift
Trend or Shift: Failure in reagent dispense system
Shift
Trend or Shift: Inaccurate calibration/recalibration
Shift
This encompasses all endeavors, procedures, and activities directed towards ensuring that a specified quality or product is maintained.
Includes pre-, analytical, and post-analytical.
Quality Assurance
Concerned with analytical phase of quality assurance
Internal (Intralab)
External (Interlab)
Quality Control
This compares observed control values with the control limits and provide a visual display that is easy to inspect and review.
Quality Control Chart
Most commonly used QC chart
Levey-Jennings Chart
Independent variable of Levey-Jennings Plot
X-Axis (Day/Time)
Analyte concenrtation of Levey-Jennings
Y-axis
Uses series of control rules to interpret data. This chart detects errors.
Westgard Multirule Chart
Systematic Errors of Westgard Rules
EVEN NUMBERS
- 2 2s
- 4 1s
- 10x
Random Errors of Westgard Rules
ODD numbers
-1 2s
- 1 3s
- R 4s
This westgard rule is a warning rule where one of the two controls falls outside 2SD
1 2s
Westgard rule: EITHER of the two control falls outside of 3SD. Run must be rejected
1 3s
Westgard rule: 2 consecutive values for the same level falls outside of 2SD in the same direction or both controls in the same run exceed 2SD
2 2s Rule
One control exceeds the mean by -2SD, and the other control exceeds the mean by +2SD. The range between two results will therefore exceed 4SD.
R 4s
Required control data from previous run. Four consecutive QC results for one level of control are outside 1SD or both levels of control have consecutive results outside SD
4 1s
Requires control data from previous runs. Ten consecutive QC result for one level of control are on one side of the mean or both levels of control have five consecutive results that are on the same side of the mean.
10x
Indicator of dispersion
Standard Deviation
Relative indicator of precision / Index of Precision
CV
Interpret a high CV
Results are highly variable. Poor precision.I
Interpret a low CV
Good precision
Indicate percentages of the following inside the curve:
1SD, 2SD, 3SD
1SD = 68.3%
2SD = 95.5%
3SD = 99.7%
Chart “earliest indicator of systematic errors”
CUSUM
Chart: increased and decreased serum error.
45 degree angle is dependent systematic error
Youden-Twin
Diagnostic specificity formula?
TN/TN+FN x 100
Diagnostic sensitivity formula?
TP/TP + FN x 100
PPV formula?
TP/TP + FP x 100
NPV Formula?
TN/TN+FN x 100
This method of analysis has the ability to detect the SMALLEST AMOUNT OF ANALYTE
Analytical Sensitivity
This method of analysis has the ability to detect ONLY the analyte of interest
Analytical Specificity
This is the ability of assay to maintain both accuracy and precision over an extended period of time
Reliability
Type of reliability: closeness of values to the repeated values after repeating during SAME CONDITIONS
Repeatability
Type of reliability: closeness of value to the reported value after repeating during CHANGED CONDITIONS
Reproducibility
This effect is due to improper product manufacturing
Matrix Effect
Define a standard
Solutions of known PURE CONCENTRATION