External Quality Assessment (EQA) schemes are national or transnational programmes designed to control the analytical performance of clinical laboratories and to maintain inter-laboratory variability within acceptable limits. In such EQA programmes, participants are usually grouped by the type of assay technique/equipment they use. The coefficient of variation (CV) is a simple tool for comparing the inter-laboratory reproducibility of such techniques: the lower the CV, the better the analytical performance.Serum protein electrophoresis, a laboratory test profile consisting of five fractions (albumin, α 1 , α 2 , β and γ globulins) summing up to 100% of total proteins, can also be assayed in different ways depending on the media or the analytical principle. We propose a multivariate coefficient of variation for comparing the performance of electrophoretic techniques in EQA, thus extending the univariate CV concept. First, the compositional nature of electrophoretic data requires a one-to-one transformation from the 5-dimensional to the 4-dimensional space.Next, robust estimations of the mean and the covariance matrix are needed to avoid the effect of outliers. The new approach is illustrated on electrophoretic datasets from the French and Belgian national EQA programmes.
The interlaboratory variability of results illustrates the difficulties encountered by diabetologists in the follow-up of diabetic patients using results obtained from different laboratories. It demonstrates the usefulness of the internationally developed standardization process of GHb measurements and points out the need for laboratories to fulfill good practices.
SUMMARY. Two lyophilized control sera were distributed through seven national external quality assessment schemes in six European countries-Belgium, Switzerland, France, The Netherlands, Sweden and the United Kingdom-participated in the study. The results for 17 routine analytes were obtained from almost 5000 laboratories for the two sera. The organizers of the schemes were asked to process the results according to a common outlier removal procedure, and submit methodrelated data if available. The two sera were also distributed through the external/internal scheme of The Netherlands, and the within-laboratory standard deviations calculated in this scheme have been used in a scaling procedure for the external mean values and between-laboratory standard deviations of the participating countries.The results show remarkable agreement in the national mean values for practically all analytes, but considerable differences in the between-laboratory variation. Data from comparable method groups was obtained for 12 analytes from Belgium, France, The Netherlands and the UK. Though revealing some specific differences between methods and countries, the method-related data are generally in agreement with the all-method data. In this study reference method values were only available for cholesterol. The high degree of agreement found suggests, however, that mutual recognition of all-method mean values in national schemes could be acceptable, especially for analytes for which reliable reference methods are not available. The major element of variation is between-laboratory rather than between-country.
Additional key phrases: analysis of variation; external quality assessmentExternal quality assessment is widely recognized as a means for interlaboratory comparison of analytical performance. In many countries surveys are conducted on a regular basis and results are processed in National Schemes.' In Europe a wide variety of National External Quality
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