Table 1.
Examples of ongoing pre-analytical EQAS.
| Method | Pre-analytical issues studied | Frequency | Performed by |
|---|---|---|---|
| Type I. Registration of procedures | |||
| Registration of procedures via web-based multiple choice questionnaire | Clinical chemistry: Hemolysis, stability of samples (2011) Hemostasis testing: Phlebotomy, sample handling and sample acceptance (2012) Glucose: Sample handling and sample treatment (2013) |
1 × year | Norwegian Clinical Chemistry EQA program (NKK) Not published |
| Registration of procedures via web-based multiple choice questionnaire | Hemostasis testing | 2 × year | ECAT/INSTAND 2011 (25) |
| Clinical case-based European EQAS covering pre-analytical, analytical and post-analytical phase. Five sets of multi-specimen samples | Porphyria: Case history based test ordering | 2 × year | Norwegian Porphyria Centre (NAPOS)/The European Porphyria Network (EPNET (26) |
| Registration of procedures via web-based multiple choice questionnaire | 5 general pre- and post-analytical questions, 5 questions within specific disciplines (i.e. coagulation, hematology, immunology, microbiology) | 2 × year | * Quality Control Center Switzerland (CSCQ) |
| Registration of procedures via multiple choice questionnaire | Urine chemistry, clinical chemistry | 4 × year | * WEQAS |
| Registration of procedures via web-based multiple choice questionnaire | Hematology, sample handling | 1 × year | * INSTAND |
| Type II. Circulation of samples simulating errors | |||
| Circulate samples for extraction of RNA/DNA | Sample preparation for DNA and RNA testing | 1 × year | SPIDIA-DNA, 2012 SPIDIA-RNA, 2011 European Commission (EC) (33, 34) |
| Circulate samples | Sample indicies – lipemic, icteric, hemolysis index | 4 × year | * WEQAS |
| Type III. Registration of errors/adverse events | |||
| Q-Track (since 1998, 1 × year, ongoing) programs, registration of error rates | Patient/sample identification, specimen handling/preparation, specimen acceptability, customer satisfaction | 4 × year | College of American Pathologists (CAP) (39) |
| Registration of rejection of samples | Registration of the rejection rate and causes for rejecting the samples during 1 month or 100 rejections | 2 × year | Committee for the Quality of the Extra-analytical phase (started within The Spanish Society of Clinical Chemistry and Molecular Pathology (SEQC) in 1998 (41) |
| Registration of key incidents which represent either the most frequent or most serious incident | Patient identification, incorrect patient preparation, phlebotomy, sample preparation/handling and sample acceptability | 4 × year | Key Incident Monitoring and Management Systems Quality Assurance (KIMMS QA) 2009 (43). |
*
Personal communication at the EQALM meeting in Bucuresti in 2013 where the participants were asked if they had any pre-analytical EQAS. Three EQA organizers replied: WEQAS (Annette Thomas, http://www.weqas.com/eqa/index.html) INSTAND (http://www.instandev.de), and CSCQ (Dagmar Kesseler, http://www.cscq.ch)