The Westgard Rules

What's New on Westgard Web: April 2011

Posted by Sten Westgard, MS

Here are the articles that have been recently added to Westgard Web:

QC Reality Check, Part 3

Dietmar Stockl, PhD, continues his series on real-world internal QC (IQC) scenarios. What happens when the laboratory purposely sets the wrong target?

Shouldn't different modules of the same instrument produce the same result?

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QC for the Future, Six Years Later

Back in 2005, CLSI held a conference on "QC for the Future." At the time, the specific future that CLSI envisioned was expected to reach us shortly, with promises of accelerated ratification of new guidelines. The road to the future was longer than anticipated, as it turns out, and we may have ended up in a different place.

What's the future of QC for the future?

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Sigma-metric Analysis: Olympus AU2700 Plus

A 2010 study assessed the performance of an Olympus AU2700 plus using biologically-derived specifications for maximum imprecision and maximum bias. So what would happen if we applied biologically-derived specifications for allowable total error? Or, for that matter, if we applied Rilibak or CLIA quality requirements?

Sigma-metrics with different quality requirements: AU2700 plus

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Error Rates in the Total Testing Process

For more than a decade, conventional wisdom has it that analytical errors happen so rarely that we can safely ignore them and concentrate on other problems. But a new 2011 study, looking back on 5 years of data, challenges that assumption.

What are the Sigma-metrics of pre-analytical errors?

Happy Lab Week Discounts!

Posted by Sten Westgard, MS

It's time to celebrate Laboratory Professionals again. The unsung, unfortunately often invisible, heroes of the medical community. Laboratory Professionals do indeed get results - and the public and the clinicians don't appreciate how vital that information is.

As part of our appreciation, Westgard Web is offering two online discounts:

HAPPYLABWEEK   
This coupon code is good for 10% off any purchase at the online store during LabWeek.

Now, we know that you're going to be very busy during LabWeek itself, what with all the parties and acclaim that mark this celebration. Other organizations are offering discounts during LabWeek as well. So, between the festivities and all the competing offers, you might not get to our online store during LabWeek.

So we've got a second online discount for you:

LABWEEKHANGOVER   
This coupon code is good for 15% off any purchase at the online store.

This second coupon is valid until the end of the following week (May 6th), not just during LabWeek.

[The fine print: one discount per person, per order only; cannot be combined with other offers; discount applies to online orders placed through westgard.com only; Oh, and yes, if you're wondering, both coupons are active right now, so you can decide which one to use...]

Best Practices in Laboratory Medicine, 2011

Posted by Sten Westgard, MS

Do you remember the LMBP? This is the initiative sponsored by the CDC to seek out, evaluate and recommend Best Practices for Laboratory Medicine.

They're still at it, and here's a list of their current projects in development:

QUALITY ISSUE / PROBLEM: Biochemical Markers of Acute Myocardial Infarction:
https://www.futurelabmedicine.org/get_involved/public_comments/markers_ami.aspx
 
QUALITY ISSUE / PROBLEM: HEMOLYSIS (RED BLOOD CELL DAMAGE):
https://www.futurelabmedicine.org/get_involved/public_comments/hemolysis.aspx
 
QUALITY ISSUE / PROBLEM: Rapid Identification of Bloodstream Infections:
https://www.futurelabmedicine.org/get_involved/public_comments/rapid_identification.aspx
 
LMBP is seeking out comments from YOU on (1)Evidence review key questions and analytic framework; (2) Outcome measures of interest; or (3) Draft methods reports, etc.

If you've got something to share, LMBP wants to hear from you. And if it's about a different issue or topic, that's great, too - they're also trying to identify new problems to tackle.

 

Quality in the Spotlight 2011

Posted by Sten Westgard, MS

It's that time of year again, when the annual Quality in the Spotlight Conference is held in Antwerp, Belgium. This is an intimate gathering, one that doesn't drown you in panels, symposiums, and roundtables. You never have to worry that you're missing one talk while attending another. It's also one of the few meetings that actually focuses on the quality of testing.

Dr. Westgard gives his lecture at the Elzenveld conference center in downtown Antwerp.

As the audience sat in the spacious hall, Dr. Westgard gave an introduction to the realm of Risk Analysis, an approach that is coming soon to the US via CLSI documents. Even though the origin of many of the CLSI guidelines (EP18, EP23) can be found in ISO standards (22367, 14971), the medical laboratory community in Europe is not wholly familiar with these concepts, either.

Dr. Sharon Ehrmeyer and Dr. Westgard (in a wine cellar) at the conference dinner.

One of the highlights of the conference is the dinner and reception that follow the scientific presentations. Unlike the mega-meetings, it's possible to meet and make connections with all of the presenters and attendees to this conference. The connections and conversations that result are almost as useful as the scientific program of the meeting.

This year's "Westgard Award" went to Dr. George Klee of the Mayo Clinic.

Dr. Klee has been doing the most prominent work in the field of setting quality specifications, including a paper in Clinical Chemistry updating the usefulness of different types of quality requirements, and a focused study he conducted with thousands of patient records to determine the medical use of glucose test results (reinforcing the need to set a tighter quality requirement for glucose methods, down to 15% or even 10% from the current 20% goal). It was really useful to see Dr. Klee talk at length about these papers and his approach to quality specifications.

Here, at the close of the conference, Dr. Per Hyltoft-Petersen and Dr. Westgard discuss the next meeting.

The Quality in the Spotlight conference has been going for 15 years now, quite an achievement. Even as the discussions of this conference were unfolding, the planning for the 16th conference is underway.

Finally, a trip to Belgium without sampling the beer is a crime. Here, "the" Westgard and "a" Westgard enjoy a drink following the end of the conference.

Next year, the 16th conference will be held on March 29th and 30th. The central theme will be:

Error Budgets and Risk Management for Laboratory Medicine.

Hope to see you there in 2012!