RIQAS End-of-Cycle Report
RIQAS End-of-Cycle Report
RIQAS End-of-Cycle reports are sent to all participants who receive the standard report. Therefore, participants who are enrolled in RIQAS Urinalysis, RIQAS Urine Toxicology and RIQAS Serology programmes will not receive an End-of-Cycle report.
The RIQAS End-of-Cycle report provides laboratories with a complete summary of their External Quality Assessment performance. Performance is also compared to that of the previous cycle providing an indication of progress and improvement over time. Data is presented in both written and graphical format allowing a visual assessment of overall performance.
The RIQAS End-of-Cycle report is split into 3 sub-sections. These sub-sections are designed to allow performance assessment at a glance.
RIQAS EQA Reports
RIQAS End-of-Cycle Report Features
The Parameter Cycle Summary section provides an overview of the results returned for each sample in the cycle. The text section summarises the laboratory’s result compared to the Mean for Comparison. Laboratory performance for the current cycle is also compared to that of the previous cycle. A variety of charts including Levey-Jennings, Target Score, % Deviation by sample and % Deviation by concentration are also presented allowing a visual assessment of laboratory performance over the cycle.
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The text section provides a summary of the laboratory’s results and statistics including Mean for Comparison, SDPA, %CV, Uncertainty, SDI, Target Score and % Deviation. An additional table comparing performance for the current cycle to the previous cycle is also provided.
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The laboratory’s performance is summarised in various charts including Levey-Jennings, Target Score, % Deviation by sample and % Deviation by Concentration.
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The absolute SDI summary report compares current performance for all parameters to the previous cycle and indicates whether performance is better or worse. Performance is compared to other RIQAS participants in your country and worldwide.
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A certificate of performance is provided listing all parameters, for which the laboratory achieved an acceptable level of performance (Average Absolute SDI <2). Although the End-of-Cycle Report is issued for all registered parameters, the certificate of performance will only be available for parameters where results for at least 50% of samples in the cycle have been returned.
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RIQAS Standard Report
There are a variety of RIQAS reports designed to enable quick and easy identification of any trends or test system issues. The standard quantitative report is provided in a user-friendly, one page per parameter format allowing a visual, at-a-glance assessment of performance. The standard quantitative report is split into several easy to interpret subsections each designed to save valuable laboratory time.
You can explore each of the report sections using the table below. Don’t forget, to enlarge the image, simply click on it.
RIQAS EQA Reports
RIQAS Reports Features
Performance data is presented in a simple one page format for each analyte. Each one page report comprises seven sub-reports providing a statistical and graphical representation of laboratory performance.
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The text section provides a statistical breakdown of results by all methods, your method and instrument group. The Mean, CV% and Uncertainty or Measurement is presented for each comparison group.
Your laboratory’s result is compared to the Mean for Comparison (usually the instrument group Mean). Also included are the RIQAS performance indicators; SDI, Target Score and %Deviation.
Acceptable performance criteria:
- SDI <2
- Target Score >50
- %Deviation
The defined acceptable limits default to the RIQAS TDPA values but may be based on CLIA, biological variation or country specific limits.
Performance goals based on Biological Variation are also stated within the text section for information purposes.
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The histogram chart provides an overview of how your laboratory’s result compares to the all method group, your method group and your instrument group. Your result is represented by a black triangle; the closer to the centre the better.
The chart is intended to provide a quick visualisation of performance compared to other method groups and can be used to identify any potential bias.
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The Levey-Jennings chart plots the last 20 SDI’s and is extremely useful for monitoring EQA performance over time, allowing quick and easy identification of any trends or bias. The chart is colour coded making interpretation simple and easy; results that fall in the white area are excellent and those in the red area unacceptable.
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The Target Score (TS) chart is a unique chart which displays your laboratory’s last 20 target scores delivering an instant, visual indication of performance. The TS chart is conveniently colour coded for even easier performance assessment, a TS >50 is acceptable. The TS is a numerical index relating your %Deviation from the mean to a Target Deviation for Performance Assessment (TDPA).
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The %Deviation by sample chart displays the %Deviation for the last 20 EQA samples enabling identification of trends and shifts in performance. Similar to the other charts on the RIQAS report, the %Deviation by sample chart is shaded to indicate the limit of acceptable performance. A black dot within the white section of the chart will represent results with a %Deviation within your acceptable limits of performance; a black dot within the red section of the chart will represent results with a %Deviation outside your acceptable limits of performance. %Deviations are not influenced by the performance of your peers, as seen with the standard deviation index (SDI) and therefore is a better indicator of individual performance.
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The %Deviation by concentration chart enables easy detection of possible concentration related biases. Unlike the other charts provided on the report, the %Deviation by concentration chart displays the concentration range of the previous 20 samples along the bottom of the chart.
Using this scale along with the percentage deviation, you are provided with a rapid assessment of your %Deviation in relation to the concentration of the:
• Current sample (represented by a square)
• Your 19 previous results (represented by circles)
This chart provides an easy interpretation of potential positive or negative biases at high or low concentrations, or whether a particular sample is a random outlier.
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The Multi Method Stat Section provides you with an easy way of assessing the performance of the other methods used to analyse the parameter. This is useful when your laboratory plans to change the analytical method used for the parameter.
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Located at the back of the standard quantitative report, our quick reference summary page details the performance for each registered parameter in the programme.
Within the performance column, RIQAS provides an effortless method of assessing the performance of each parameter within the sample distribution. When a red triangle appears next to the parameter, this indicates that all performance indicators (SDI, TS and %DEV) have exceeded the performance criteria.
The performance indicator limits for each parameter are exceeded when your result produces:
• An SDI greater than +/- 2 standard deviations.
• A Target Score less than 50 (only when Target Scoring is available)
• A %Deviation greater than your set acceptable limits of performance.
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A summary CSV file is available on request to all participating laboratories. The report provides a summary of all statistics, acceptable limits and performance indicators as a .csv file for each sample in the cycle.
A retrospective statistics summary is also available, four weeks after the final submission date for parameters where a result was not submitted on time.
RIQAS Parameters List
RIQAS is the largest international External Quality Assessment (EQA)/ Proficiency Testing (PT) scheme, there are currently more than 55,000 participants in 134 countries. World renowned for reducing the number of individual programmes required by even the most demanding laboratories, RIQAS covers 360 parameters across 36 flexible multi-parameter programmes. Effective consolidation in this way will not only deliver real cost savings but free up storage space and ultimately reduce the time spent preparing multiple samples at each survey.
RIQAS Parameter List
1-25-(OH)₂-Vitamin D
17-OH-Progesterone
25-OH-Vitamin D
5-HIAA
α-1-Acid Glycoprotein
α-1-Antitryspin
α-2-Macroglobulin
ACE (Angiotensin Converting Enzyme)
Acid Phosphatase (Prostatic)
Acid Phosphatase (Total)
ACR
ACTH
AFP
Albumin
Aldosterone
Alkaline Phosphatase
ALT
ALT (ALAT)
Amikacin
Ammonia
Amylase (Pancreatic)
Amylase (Total)
Androstenedione
Anti Streptolysin O (ASO)
Anti-CMV
Anti-CMV IgG
Anti-CMV IgM
Anti-EBNA IgG
Anti-EBV VCA IgG
Anti-EBV VCA IgM
Anti-HAV IGM*
Anti-HAV (Total)*
Anti-HBc
Anti-HBc IgM*
Anti-HBe (Total)*
Anti-HBs (Total)*
Anti-HCV
Anti-HIV-1
Anti-HIV-1 & 2 Combined
Anti-HIV-2
Anti-HSV- 1 & 2 IgG Combined
Anti-HSV- 1 & 2 IgM Combined
Anti-HSV1 IgG
Anti-HSV1 IgM
Anti-HSV2 IgG
Anti-HSV2 IgM
Anti-HTLV-1 & 2 Combined
Anti-HTLV-I
Anti-HTLV-II
Anti-Measles IgG*
Antimicrobial Susceptibility Testing
Anti-Müllerian Hormone (AMH)
Anti-Mumps IgG*
Anti-Rubella IgG
Anti-Rubella IgM
Anti-SARS-COV2 IgG
Anti-SARS-COV2 IgM
Anti-SARS-COV2 Total
Anti-TG
Antithrombin III
Anti-Toxoplasma IgG
Anti-Toxoplasma IgM
Anti-TPO
Anti-TSH Receptor (TRAb)
Anti-VZV IgG*
Apolipoprotein AI
Apolipoprotein B
aPTT
AST
AST (ASAT)
β-2-Microglobulin
Benzoylecgonine
Bicarbonate
Bile Acids
Bilirubin (Direct)
Bilirubin (Total)
Blood
BNP
Buprenorphine
CA15-3
CA19-9
CA125
Caffeine
Calcitonin
Calcium
Calcium, Adjusted
Calcium (Ionised)
Cannabinoids (THC)
Carbamazepine
Carboxyhaemoglobin (COHb / HbCO)
CEA
Ceruloplasmin
Chloride
Cholesterol (Total)
Cholinesterase
Ciclosporin
CK, Total
CK-MB (Activity)
CK-MB (Mass)
CK NAC
CO2, Total
Complement C₃
Complement C₄
Conductivity
Copper
Cortisol
Cotinine
C-Peptide
C-Reactive Protein (CRP)
Creatinine
CYFRA 21-1 (Cytokeratin 19)
D-3-Hydroxybutyrate
d-Amphetamine
D-Dimer*
Deoxyhaemoglobin (HHb)
DHEA Unconjugated
DHEA-Sulphate
Digoxin
d-Methamphetamine
Dopamine
EDDP
Epinephrine
ESR
Estriol Total
Ethanol
Ethosuximide
Everolimus
Factor II
Factor IX
Factor V
Factor VII
Factor VIII
Factor X
Factor XI
Factor XII
Ferritin
Fibrinogen
Folate
Free Morphine
free β-hCG
Fructosamine
FSH
γ-GT
Galactose
Gastrin
Gentamicin
Growth Hormone (GH)
GLDH
Glucose
Haematocrit (HCT)
Haemoglobin (Hb)
Total Haemoglobin (tHb)
Haemolysis
Haptoglobin
HbA1c
HBsAG
HBDH
hCG
HDL-Cholesterol
Homocysteine
hsCRP
Icteric
IgA
IgE
IGF-1
IgG
IgM
Inhibin A
Insulin
Interferon gamma (INF-Y)*
Interleukin – 1 alpha (IL-1α)*
Interleukin – 1 beta (IL-1β)*
Interleukin – 10 (IL-10)*
Interleukin – 2 (IL-2)*
Interleukin – 4 (IL-4)*
Interleukin – 6 (IL-6)
Interleukin – 8 (IL-8)*
Iron
Kappa Light Chain (Free)
Kappa Light Chain (Total)
Ketones
Lactate
Lambda Light Chain (Free)
Lambda Light Chain (Total)
LD (LDH)
LDL-Cholesterol
Lead
Leucocytes
Lipase
Lipoprotein (a)
Lithium
Lorazepam
LSD
Luteinising Hormone (LH)
Magnesium
MDMA
Mean Cell Haemoglobin (MCH)
Mean Cell Haemoglobin Concentration (MCHC)
Mean Cell Volume (MCV)
Mean Platelet Volume (MPV)
Metanephrine
Methadone
Methaemoglobin (MetHb)
Methotrexate
Monocyte Chemoattractant Protein -1 (MCP-1)*
Myoglobin
NEFA
Nitrite
Non-HDL Cholesterol
Norepinephrine
Normetanephrine
Norpropoxyphene
Nortriptyline
NT proBNP
Oestradiol
Osmolality
Osteocalcin
Oxalate
Oxazepam
Oxygen Content (O2CT)
Oxygen Saturation (sO2 / Vol O2)
Oxyhaemoglobin (O2Hb / HbO2)
P24*
PAPP-A
Paracetamol (Acetaminophen)
pCO₂
pH
Phencyclidine
Phenobarbital
Phenytoin
Phosphate (Inorganic)
Plasma Renin Activity
Plasminogen
Plateletcrit (PCT)
Platelets (PLT)
pO₂
Potassium
Prealbumin (Transthyretin)
Primidone
Procalcitonin
Progesterone
Prolactin
Protein (Total)
Protein C
Protein S
PSA (Free)
PSA (Total)
PT (Including INR)
PTH
Red Blood Bell Count (RBC)
Red Cell Distribution Width (RDW)
Renin (Direct Concentration)
Retinol Binding Protein
Rheumatoid Factor
Salicylic Acid
Secobarbital
SHBG
Sirolimus
Sodium
Specific Gravity
Syphilis
T₃ (Free)
T₃ (Total)
T₄ (Free)
T₄ (Total)
Tacrolimus
Testosterone (Free)*
Testosterone (Total)
Theophylline
Thyroglobulin
TIBC
Tobramycin
Total hCG
Transferrin
Triglycerides
Troponin I
Troponin T
TSH
TT
Tumor Necrosis Factor alpha (TNF-a)*
UIBC
Unconjugated Oestriol
Urea
Uric Acid
Urobilinogen
Valproic Acid
Vancomycin
Vascular Endothelial Growth Factor (VEGF)*
Vitamin B₁₂
VMA
Total White Blood Cell Count (WBC)
Zinc
RIQAS – Randox International Quality Assessment Scheme
The World’s Largest External Quality Assessment Scheme
Uniquely connecting you with 45,000 laboratory participants across 32 flexible yet comprehensive programmes, RIQAS is the world’s largest external quality assessment (EQA) scheme. Access to maximised peer groups ensures availability of comparison data for a wide range of instruments and methods, ultimately increasing confidence in test system reliability. The added benefit of frequent analysis, user-friendly reports, multi-instrument reports and consolidated programmes makes a cost-effective, high quality EQA solution for any laboratory.
Benefits of RIQAS
Consolidation
Comprised of over 360 parameters in 32 comprehensive programmes, RIQAS streamlines EQA by significantly reducing the number of individual programmes required.
User-friendly reports
RIQAS presents reports in a simple one page per parameter format for at-a-glance performance assessment, including Levey-Jennings charts, Histograms, % Deviation charts, and more; providing a visual representation of laboratory performance, all within 24-72 hours of the submission deadline.
Frequency
Frequent analysis coupled with our rapid report turnaround will allow labs to pinpoint when an error occurred and implement any corrective actions necessary.
Flexibility
With 32 flexible EQA programmes available, RIQAS has something to suit every lab. Reduced parameter and report options ensures suitability for laboratories of every size and budget.
The ability to register up to 5 instruments per programme at no extra cost will ultimately save money facilitating comparative performance assessment.
Accreditation
Being part of a reputable External Quality Assessment scheme like RIQAS is highly encouraged by international and national regulatory bodies and will help your laboratory meet ISO 15189:2012 accreditation requirements:
“the laboratory shall participate in inter-laboratory comparisons such as those organised by external quality assessment schemes…”, “EQA should, as far as possible, cover the entire range of tests, and the entire examination process, from sample reception, preparation and analysis to interpretation and reporting.”
RIQAS systems and procedures are accredited to ISO 17043:2010 ‘Conformity Assessment – General Requirements for Proficiency Testing’ ensuring a high quality programme that is fit for purpose and will assist laboratories in meeting and maintaining ISO 15189:2012 standards.
In addition to ISO 17043:2010, RIQAS is recognised by the UK National Quality Assurance Advisory Panel (NQAAP) for Clinical Pathology and the Joint Working Group on Quality Assurance (JWG QA).
Learn More
To learn more or to get signed up, fill in the contact form below.
What is Measurement of Uncertainty?
Measurement Uncertainty (MU) relates to the margin of doubt that exists for the result of any measurement, as well as how significant the doubt is. For example, a piece of string may measure 20 cm plus or minus 1 cm, at the 95% confidence level. As a result, this could be written: 20 cm ±1 cm, with a confidence of 95%. Therefore, we are 95% sure that the piece of string is between 19 cm and 21 cm long.
Standards such as ISO 15189 require that the laboratory must determine uncertainty for each test. However, they have not specified how this should be done.
How do we calculate Measurement Uncertainty using QC data?
Employing your QC data to calculate uncertainty makes several assumptions; your test system is under control, the patient samples are treated in the same manner as your controls and gross outliers have been removed. If you choose to use your QC data to calculate this you should ensure that you use a commutable control with a matrix similar to that of a patient sample, with analytes present at clinically relevant levels
To calculate MU, labs must look at the intra-assay precision and inter-assay precision of their test.
Intra-assay precision: Sometimes known as ‘within run’ precision, is where 20 or more replicates of the same sample are run at the same time, under the same conditions (calculated from a single experiment). Intra-assay precision helps to assess systematic uncertainties
Inter-assay precision: Sometimes known as ‘between run’ precision, is where 20 or more replicates are run at different times – e.g. 1 replicate every day for 20 days (can be calculated from routine IQC data). Inter-assay precision can help identify random uncertainties within the test system.
*The Australian Association of Clinical Biochemists (AACB) recommends that at least 6 months’ worth of QC data are used when calculating the inter-assay precision1.
Once the data is collected, you must calculate the standard error of the mean (SEM) of the intra-assay precision (A) and the SD of the inter-assay precision (B) in order to measure the uncertainty (u). Once A and B have been calculated, they need to be squared, added together and the square root of the sum found:
As uncertainty is calculated as SD and 1SD is equal to 68% confidence on a standard Gaussian curve, we can conclude that if we multiply using a coverage factor of 2, we can attain 2SD confidence of 95%. This is known as the Expanded Uncertainty (U):
What is the Advantage of Measurement Uncertainty for a lab?
Labs need to carry out MU as it is a requirement of ISO 15189. It states: “The laboratory shall determine measurement uncertainty for each measurement procedure, in the examination phases used to report measured quantity values on patients’ samples. The laboratory shall define the performance requirements for the measurement uncertainty of each measurement procedure and regularly review estimates of measurement uncertainty”.
MU also helps determine whether the difference between two results is negligible due to uncertainty or significant due to a genuine change in condition of the patient; giving labs a greater confidence in reported results.
How can Randox help?
Our new Acusera 24.7 Live Online software provides automatic calculation of MU, saving valuable time and helping labs meet ISO 15189 requirements with ease.
Contact marketing@randox.com to find out how your lab can benefit from Acusera 24.7 Live Online
Take steps to prevent incorrect patient results by making one simple change
According to the NHS Litigation Authority; in 2015 within the UK alone, £193,680,744.30 was spent on ‘wrong diagnosis’ or ‘failed/delayed diagnosis’ causing huge financial strain and impact on labs.
With approximately 75% of clinical decisions and diagnosis based on laboratory test results. The only way to guarantee a high degree of accuracy is to implement a good Quality Control plan. The importance of this is recognised globally, several bodies exist internationally including ISO (International organisation for standardisation) who have developed a set of guidelines and quality systems to ensure the reliability of laboratory test results.
So what can you do to improve accuracy and reliability?
Choose a third party QC
ISO 151589:2012 Section 5.6.2.2 states that “the use of third party control materials should be considered, either instead of, or in addition to, any control materials supplied by the reagent or instrument manufacturer”.
First Party Controls are those manufactured by the instrument/reagent manufacturer. These controls are optimised specifically for use with the manufacturers test system and therefore will mask a multitude of weaknesses. First Party Controls tend to result in perceived accuracy and a biased assessment of performance.
Third Party Controls on the other hand are designed to be completely independent and are not optimised for use with a specific test or system. Leading manufacturers of third party controls will assign target values based on data collected from thousands of independent laboratories, ensuring the availability of statistically robust multi-method, multi-analyser data. Therefore laboratories using Third Party Controls can be assured of unbiased error detection across multiple platforms.
Randox Acusera is a world leading manufacturer of true third party controls providing a cost effective, high quality solution for any laboratory-regardless of size or budget.
Look out for QC samples with clinically relevant concentrations
ISO 15189:2012 states that ‘The laboratory should choose concentrations of control materials wherever possible, especially at or near clinical decision values, which ensure the validity of decisions made’.
It is important to assess the full clinical range of an assay i.e. the range between the lowest and highest results which can be reliably reported. In order to make sure a laboratory instrument is performing accurately across the full clinical range and in particular at the medical decision level, QC materials that cover low, normal and elevated concentrations should be used.
Due to the superior manufacturing process used by Randox, QC target values consistently cover the MDL of tests. By ensuring the controls in use cover clinical decision levels laboratories can be confident of the reliability and accuracy of the patient results they release.
Opt for a commutable control material
A good QC material has many essential properties but above all, controls must perform consistently and reflect the performance of patient samples – if a control meets these requirements then we can say it is commutable. Having a commutable control would aid in the prevention of incorrect patient results because they replicate the performance of a patient sample and react to the test system in a similar manner. Use of a commutable control will also reduce costly shifts in QC target values when reagent batch is changed.
At Randox we take quality seriously, that’s why all QC products are manufactured to the highest possible standard, delivering controls of unrivalled quality. Designed to be commutable, the Acusera range will ensure accurate and reliable instrument performance while simultaneously helping laboratories to meet ISO 15189:2012 requirements. A good QC process will include the use of Third Party Controls, Clinically Relevant Concentrations and controls which can be described as commutable. By employing Quality Control’s that encompass these traits, a laboratory professional can be certain that they have taken the necessary steps to decrease incorrect results and therefore potential misdiagnosis.
