Moving average quality control: principles, practical application and future perspectives

Abstract

Moving average quality control (MA QC) was described decades ago as an analytical quality control instrument. Although a potentially valuable tool, it is struggling to meet expectations due to its complexity and need for evidence-based guidance. For this review, relevant literature and the world wide web were examined in order to (i) explain the basic concepts and current understanding of MA QC, (ii) discuss moving average (MA) optimization methods, (iii) gain insight into practical aspects related to applying MA in daily practice and (iv) describe future prospects to enable more widespread acceptance and application of MA QC. Each of the MA QC optimization methods currently available has their own advantages and disadvantages. Recently developed simulation methods provide realistic error detecting properties for MA QC and are available for laboratories. Operational MA management issues have been identified that allow developers of MA software to upgrade their packages to support optimal MA QC application and guide laboratories on MA management issues, such as MA alarm workup. The new insights into MA QC characteristics and operational issues, together with supporting online tools, may promote more widespread acceptance and application of MA QC.

Quality Control Strategy for Automated CBC: A Laboratory Point of View Deducted from an Internal Study Organised in an Emergency Laboratory

“…For Cell-Dyne Ruby instrument, commercial control and moving average were used together to assure an increased error detection. Moving average is a useful tool as a QC instrument, both in method stability evaluation and in assuring a continuous internal quality control, especially when the QC material has limited stability (11). Much of the efforts made by laboratories are directed towards SQC or different QC strategies, but an important part of the total testing process remains out of the control of the laboratory (12) (13).…”

Optimizing moving average control procedures for small-volume laboratories

“…Therefore, the first criterion for us was to establish an MA procedure for each analyte that would be capable of detecting a clinically significant bias within the daily number of tests, which would otherwise not be detected till the next morning, or until the next measurement of the control sample. Establishing such procedures should allow us to develop a quality control plan that will not require additional measurements of commercial control samples, even in the case of tests with low sigma values ( 13 ). We considered allowable total error (TEa) as clinically significant bias.…”

“…We considered allowable total error (TEa) as clinically significant bias. The second criterion we managed in the optimization was that the MA procedure was capable of detecting all biases greater than the TEa, since all of them, of course, are clinically significant ( 13 , 14 ). By combining these two criteria, we made individual compromises for each analyte.…”

When internal quality control is insufficient or inefficient: Consider patient-based real-time quality control!

“…Recently, however, new methods to obtain optimized and validated PBRTQC have been described. 2 These methods are based on running realistic error detection simulations that reflect true laboratory PBRTQC performance. 2,[17][18][19] They require a manageable number of PBRTQC alarms and therefore use much stricter false-alarm criteria than iQC, which is essential for practical application of PBRTQC.…”

“…2 These methods are based on running realistic error detection simulations that reflect true laboratory PBRTQC performance. 2,[17][18][19] They require a manageable number of PBRTQC alarms and therefore use much stricter false-alarm criteria than iQC, which is essential for practical application of PBRTQC. A major breakthrough is that one of these methods has been made available online in the MA Generator application, so that laboratories can readily use the advanced simulation techniques to set up and validate their laboratory-specific PBRTQC procedures.…”