Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme

Bukve, Tone; Røraas, Thomas; Riksheim, Berit Oddny; Christensen, Nina Gade; Sandberg, Sverre

doi:10.1515/cclm-2014-0483

Cited by 9 publications

(4 citation statements)

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“…Coupled with the individual tester group results, these findings suggest that PT implementation has a positive impact on performance. Possible reasons for this improvement could have been the site supervisory visits (SSVs) by the NRL experts [ 45 ], as well as improved adherence to testing procedures, which could be directly linked to increased training. These findings suggest the need for EQA programs in collaboration with their MOHs to prioritize investment in SSVs as well as training of testers, regardless of setting or profession, for enhanced performance.…”

Section: Discussionmentioning

confidence: 99%

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

et al. 2016

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BackgroundDespite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia.MethodsAccuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT) exercises conducted in 2009 (n = 282 sites) and 2010 (n = 488 sites). Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS) were issued to testing sites by the national reference laboratory (NRL). Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively.ResultsOverall accuracy level was 93.1% (95% CI: 91.2–94.9) in 2009 and 96.9% (95% CI: 96.1–97.8) in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy.ConclusionThe study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened.

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Section: Discussionmentioning

confidence: 99%

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

et al. 2016

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“…Failing laboratories must analyse the reasons for the failure, report the results, and initiate corrective action. Over the years, there has been a progressive decline in the number of errors, demonstrating that education and regulatory oversight are major contributors to improved EQAP performance and, by extension, patient care ( 14 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

Survey on reporting of epithelial cells in urine sediment as part of external quality assessment programs in Brazilian laboratories

Poloni¹,

Vieira

Santos³

et al. 2021

Biochem. med. (Online)

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Introduction Epithelial cells (ECs) are structures regularly observed during urine microscopy analysis. The correct identification of EC subtypes can be useful since renal tubular epithelial cells (RTECs) are clinically relevant. We investigate the urinary ECs report and the judgement of its clinical importance by Brazilian laboratories. Materials and methods A survey with four questions was made available to participants of the Urinalysis External Quality Assessment Program (EQAP) from Controllab. Laboratories composed 3 groups: (1) differentiating ECs subtypes: “squamous”, “transitional” and “RTECs”; (2) differentiating ECs subtypes: “squamous” or “non-squamous” cells; (3) without ECs subtype identification. Participants did not necessarily answer to all questions and the answers were evaluated both within the same laboratory’s category and within different categories of laboratories. Results A total of 1336 (94%) laboratories answered the survey; Group 1, 119/140 (85%) reported that ECs differentiation is important to the physician and 62% want to be evaluated by EQAP, while in Group 3, 455/1110 (41%) reported it is useful to them, however only 25% want be evaluated by EQAP. Group 2 laboratories 37/51 (73%) reported that the information is important, but only 13/52 (25%) are interested in an EQAP with differentiation of the 3 ECs subtypes. Conclusion Most of the laboratories do not differentiate ECs in the three subtypes, despite the clinical importance of RTECs. Education of laboratory staff about the clinical significance of urinary particles should be considered a key priority.

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“…In addition to education, site visits, and instrument evaluations, Noklus offers external quality assurance (EQA) schemes for many analytes. The analytical quality of POC testing improves over time with Noklus participation [15,16], and for several HbA 1c POC instruments, the analytical quality in primary care has been shown to be comparable to that of hospital laboratories [17].…”

Section: Introductionmentioning

confidence: 99%

Availability and analytical quality of hemoglobin A_1c point-of-care testing in general practitioners’ offices are associated with better glycemic control in type 2 diabetes

Tollånes¹,

Jenum

Berg

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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AbstractBackgroundIt is not clear if point-of-care (POC) testing for hemoglobin A1c (HbA1c) is associated with glycemic control in type 2 diabetes.MethodsIn this cross-sectional study, we linked general practitioner (GP) data on 22,778 Norwegian type 2 diabetes patients to data from the Norwegian Organization for Quality Improvement of Laboratory Examinations. We used general and generalized linear mixed models to investigate if GP offices’ availability (yes/no) and analytical quality of HbA1c POC testing (average yearly “trueness score”, 0–4), as well as frequency of participation in HbA1c external quality assurance (EQA) surveys, were associated with patients’ HbA1c levels during 2014–2017.ResultsTwenty-eight out of 393 GP offices (7%) did not perform HbA1c POC testing. After adjusting for confounders, their patients had on average 0.15% higher HbA1c levels (95% confidence interval (0.04–0.27) (1.7 mmol/mol [0.5–2.9]). GP offices participating in one or two yearly HbA1c EQA surveys, rather than the maximum of four, had patients with on average 0.17% higher HbA1c levels (0.06, 0.28) (1.8 mmol/mol [0.6, 3.1]). For each unit increase in the GP offices’ HbA1c POC analytical trueness score, the patients’ HbA1c levels were lower by 0.04% HbA1c (−0.09, −0.001) (−0.5 mmol/mol [−1.0, −0.01]).ConclusionsNovel use of validated patient data in combination with laboratory EQA data showed that patients consulting GPs in offices that perform HbA1c POC testing, participate in HbA1c EQA surveys, and maintain good analytical quality have lower HbA1c levels. Accurate HbA1c POC results, available during consultations, may improve diabetes care.

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Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme

Cited by 9 publications

References 5 publications

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

Survey on reporting of epithelial cells in urine sediment as part of external quality assessment programs in Brazilian laboratories

Availability and analytical quality of hemoglobin A_1c point-of-care testing in general practitioners’ offices are associated with better glycemic control in type 2 diabetes

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Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme

Cited by 9 publications

References 5 publications

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

Survey on reporting of epithelial cells in urine sediment as part of external quality assessment programs in Brazilian laboratories

Availability and analytical quality of hemoglobin A1c point-of-care testing in general practitioners’ offices are associated with better glycemic control in type 2 diabetes

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Availability and analytical quality of hemoglobin A_1c point-of-care testing in general practitioners’ offices are associated with better glycemic control in type 2 diabetes