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Or that number could be in the form of a clinical decision interval (D int), which is a gray zone of interpretation for patient treatment. That number could be in the form of a total allowable error (TE a), such as the CLIA proficiency testing criteria for acceptable performance. Sounds simple, doesn't it? But when I ask the laboratory professionals "What quality is needed for a test?" the answer is seldom a numeric or quantitative definition of the quality requirement. Quality management begins with the knowledge of the quality that needs to be achieved. Define the quality that is needed for each test. QC needs to be done right from the start. If your QC software is doing things wrong, no amount of effort on your part can correct for those problems. It's important to understand the problems (worst practices) in order to implement proper solutions (best practices). Now that we've cleared the air about the "worst practices", it's time to talk about "best practices" for doing QC right. In a previous discussion, we described some of the "abuses, misuses, and in-excuses" involving the improper implementation and interpretation of "Westgard Rules" by instruments, LIS devices, and data workstation QC software. Interpret multirules to help indicate the occurrence of random error or systematic error. Only use multirules for which error detection characteristics are known. 10: Define explicitly the application and interpretation of rules within and across matreials and runs.Built and interpret multirules in a logical order and adapt the rules to fit with different Ns Use multistage QC designs for methods with undesirable performance Use multirule QC procedures for methods with moderate to low performance Use single-rule QC procedures and moderate number of control measurements (N) for methods with moderate to high performance Use single-rule QC procedures and minimum number of control measurements (N) for methods with high performance Relate the QC procedure for the test to the Sigma-performance of the method. Calculate the Sigma-metric of your testing process. Know the performance of your method (CV, bias).
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So we've catalogued some of the worst abuses of "Westgard Rules." What about the best uses? What's the best way to use "Westgard Rules" - and When, Why, How and Who, too? Here is a list of 12 practices to make your use of "Westgard Rules" better.
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