Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays

Huub H. van Rossum; Hans Kemperman

doi:10.1515/cclm-2016-0696

Article

Implementation and application of moving average as continuous analytical quality control instrument demonstrated for 24 routine chemistry assays

Huub H. van Rossum and Hans Kemperman

Published/Copyright: January 11, 2017

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 8

Abstract

Background:

General application of a moving average (MA) as continuous analytical quality control (QC) for routine chemistry assays has failed due to lack of a simple method that allows optimization of MAs. A new method was applied to optimize the MA for routine chemistry and was evaluated in daily practice as continuous analytical QC instrument.

Methods:

MA procedures were optimized using an MA bias detection simulation procedure. Optimization was graphically supported by bias detection curves. Next, all optimal MA procedures that contributed to the quality assurance were run for 100 consecutive days and MA alarms generated during working hours were investigated.

Results:

Optimized MA procedures were applied for 24 chemistry assays. During this evaluation, 303,871 MA values and 76 MA alarms were generated. Of all alarms, 54 (71%) were generated during office hours. Of these, 41 were further investigated and were caused by ion selective electrode (ISE) failure (1), calibration failure not detected by QC due to improper QC settings (1), possible bias (significant difference with the other analyzer) (10), non-human materials analyzed (2), extreme result(s) of a single patient (2), pre-analytical error (1), no cause identified (20), and no conclusion possible (4).

Conclusions:

MA was implemented in daily practice as a continuous QC instrument for 24 routine chemistry assays. In our setup when an MA alarm required follow-up, a manageable number of MA alarms was generated that resulted in valuable MA alarms. For the management of MA alarms, several applications/requirements in the MA management software will simplify the use of MA procedures.

Keywords: moving average; quality assurance; quality control

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: H.H.R. is registered as the inventor on a filed patent describing the MA optimization and validation procedure applied. H.H.R. is owner and director of the Huvaros B.V. company that holds an exclusive license of the MA optimization and validation procedure applied.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-8-5

Accepted: 2016-11-2

Published Online: 2017-1-11

Published in Print: 2017-7-26

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Articles in the same Issue

https://doi.org/10.1515/cclm-2016-0696

Keywords for this article

moving average; quality assurance; quality control