APPLICATION OF QUALITY GOAL INDEX RATIO FOR EVALUATION THE QUALITY SYSTEM OF HbA1C ON TOSOH HPLC-723G11 ANALYZER

Bùi Thị Hồng Châu1,, Nguyễn Thị Băng Sương1,2, Nguyễn Ngọc Bích Thảo2, Nguyễn Thanh Trầm1
1 University of Medicine and Pharmacy at Ho Chi Minh City
2 University Medical Center Ho Chi Minh City

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Abstract

Background: Hemoglobin A1c (HbA1c) it plays a major role in diagnosing and managing diabetes. Reliable results are the primary goals of medical laboratories. Sigma metrics is an important tool to evaluate the errors in quality control of laboratory systemby combining bias, precision, and total allowable error (TEa). Quality goal index (QGI) is a newer parameter to represent the relative extent to which both bias and precision meet their respective quality goals. Objects: The aim of our study was to apply the QGI to evaluate the analytical performance of HbA1c on TOSOH HPLC-723G11 analyzer based on intenal quality control (IQC) data. Methods: this is a retrospective study, two levels of controls of HbA1c were run on a TOSOH HPLC-723G11 analyzer. Data were extracted over a period of 11 months, between July 2020 and June 2021. For Bias CV%,  and SD, values that the firm provided from IQC results. 6% were basis for the allowed total error values (NGSP). Monthly process sigma level and QGI were calculated subsequently. Results: The sigma metrics for internal quality control level 1 meet acceptable performance with sigma metrics between 3 and 6, of which 7 months had metrics between 3 and 4 . For level 2, all of months achieved six sigma with metrics 6, which showed excellent world class performance. The QGI indicated that seven months of level 1 had sigma scale between 3 and 6, the main problem was imprecision (QGI<0.8) except in July-2020, November-2020, June-2021 showed both imprecision and inaccuracy (0.8≤ QGI ≤ 1.2). Conclusions: In our study it was observed that HbA1c test is in conformity with the process sigma levels according to IQC and it was also evaluated as favorable considering our laboratory performance. On the basis of sigma metrics and QGI, it may be concluded HbA1c on TOSOH HPLC-723G11 was able to achieve good performance and required modification in quality control procedure as their QGI.

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References

1. American Diabetes Association (2014). Executive summary: standards of medical care in diabetes–2014. Diabetes Care, 37:S5–S13.
2. Thomas V, Desai PB, Mithrason AT (2018). Evaluation of clinical biochemistry laboratory performance using sigma metrics. Int J Clin Biochem Res, 5(4):604–7. doi:10.18231/2394-6377.2018.0128.
3. Aggarwal K, Patra S, Acharya V, Agrawal M, Mahapatra SK (2019). Application of six sigma metrics and method decision charts in improvising clinical Chemistry laboratory performance
4. enhancement. Int J Adv Med, 6(5):1524–30. doi:10.18203/2349- 3933.ijam20194155.
5. Adiga US, Preethika A, Swathi K (2015). Sigma metrics in clinical chemistry laboratory - A guide to quality control. Al Am een J Med Sci, 8: 281-287.
6. Kumar BV, Mohan T (2018). Sigma metrics as a tool for evaluating the performance of internal
7. Quality control in a clinical chemistry laboratory. J Lab Physicians, 10(2):194-99.
8. Parry DM (2019). Quality goal index. Available at: https://www.westgard.com/guest34.htm
9. Westgard JO (2003). Internal quality control: planning and implementation strategies. Ann Clin Biochem, 40(Pt 6):593-611.
10. Bozkaya G, Uzuncan N, Bilgili S, Demirezen O (2019). Evaluation of Analytical Performance of Variant II Turbo HbA1c Analyzer According to Sigma Metrics. J Med Biochem,38:33–37. 19. 9.İren Emekli D, Güçlü K, Nar R, Avcı E (2020). Assesment of Analytical Performance of HbA1C Test by Six Sigma Methodology. J Basic Clin Health Sci, 4:104-107.