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Date : DD-MMM-YYYY
Feedback
Page 1
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
Quality ManagerPathology LaboratoryBiochemistry DepartmentTownCountyPostcode
This Scheme is essentially web-based. We can alert you to information regarding the Scheme via email. The e-mail address (or addresses) we are currently using to contact your laboratory is shown below in red . If no e-mail address is displayed or the information shown is incorrect, please email us with an appropriate contact e-mail address as soon as possible, using the word 'feedback' in the title line.
Based on the date information you have provided, the transit time from specimen dispatch [ ] to receipt [ ] was day(s), and the subsequent time to analysis [ ] in your laboratory was day(s). (Missing values indicate dates not provided. "0 days" represents same day).
Any comments you made to us are shown below and have been acted upon where necessary
Any specific comments applicable only to laboratory are shown below
Any general comments applicable to all laboratories are shown below
Please see the commentary page. Feedback would be most welcome
Report authorised Friday 19 June 2015 by:
Finlay MacKenzie Director, UK NEQAS for Sweat Testing
Birmingham Quality is a UKAS accredited proficiency testing provider No. 7860. Please see http://www.ukas.com for full details of the accreditation status of our services
Birmingham Quality is proud to offer EQA services that adhere to the Code of Practice and have the badge of quality of UK NEQAS
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Distribution : 128 Date : DD-MMM-YYYY
Performance Summary Icons (click graph for details)
Page 2
for Sweat Testing Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
B s
core
C score
Sweat Chloride
P-ABCPENR (DASH1)
0 5 10 15
-15
-10
-5
0
5
10
15
B s
core
C score
Sweat Conductivity
P-ABCPENR (DASH1)
0 5 10 15
-15
-10
-5
0
5
10
15
B s
core
C score
Sweat Sodium
P-ABCPENR (DASH1)
0 5 10 15
-15
-10
-5
0
5
10
15
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Date : DD-MMM-YYYY
Participation summary
Page 3
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
All our time periods are 'rolling' to give you current information. You may wish to keep you own log of Calendar Year or Financial Year time points if you require 'year-end' statements for your own internal use. Any analytes with out of consensus performance will be highlighted in red and can be clicked for further details.
Sweat Conductivity Sweat Sodium
You have out of consensus performance for:
You have no performance data for:
You have in consensus performance for: Sweat Chloride
None
None
Analytical Performance over the last 6 months (rolling time window of 6 distributions)
This scheme cycle is notionally every four weeks. Analytically, we assess you over a six month time window (6 Distributions). For return rates, late and amended results we assess you over a twelve month period (12 distributions).
1 distribution accepted from the last 12
0 distributions from the last 12
Amendments
Satisfactory12 distributions out of a possible 12
Satisfactory
SatisfactoryLate Returns
Participation
Distributions Rating
Participation and Return Rates
You can judge, in association with your IQC and other QA measures, if your current performance is a blip or part of a trend.
In consensus for all specimens for:
Out of consensus for at least one specimen for:
You are not registered for:
Sweat Chloride Sweat Sodium
You have no specimen data for:
Sweat Conductivity
None
None
None
Analytical Performance for specimens from distribution 128 only
The new Participation Summary page is an exciting new feature which we hope you will like. It is currently in prototype mode but will ultimately expand into having the Interpretative analytes as well as the existing ‘numerical’ analytes listed and will contain turnaround graphs etc., too.
For the moment it would be helpful if you could check the accuracy of the data presented, particularly the return-rate elements.
Many thanks, Finlay
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Date : DD-MMM-YYYY
Distribution Summary
Page 4
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
%biasBResult A score C scorePool CB scoreTargetSpecimen ASpecimen
IN
42
128A
41
128C
+2.9
41.0
128A
+2.9
232
41
+0.2+0.7
2.3
I
230
61
232
Conductivity interp
232
+3.0231
2.4
231232
40.8230
128C
128A
N
I
("units")
230
+1.0
69
230
231
-0.1
231+0.3128C
I
N
64
(mmol/L)
128C
(N, I or E)
57.6
128B N231
(mmol/L) 39.8Sweat Chloride
128B
128B
43
(N, I or E)N
-0.4Sweat Sodium
128A
128B
68.8
N
Chloride interp
58
41
40.2
50 -0.8
+2.1
60.4
39.9
N
128A
232
+2.7
128B2.1
53
Sweat Conductivity
230
128C I
49.9
41
If your laboratory is outside of the acceptable limits of performance for any its rolling time-window scores (A, B or C scores), this will be indicated by a red traffic light symbol. It is the responsibility of the laboratory to undertake an internal investigation to establish the underlying cause and put in place corrective and preventive action. Please do not wait to receive a formal notification of performance from the Scheme Organiser or the National Quality Assurance Advisory Panel (NQAAP) before logging the non-conformity and, where necessary, acting upon the data contained in your report. A green traffic light merely reflects that your laboratory is performing as well as the state-of-the-art allows; it does not necessarily mean that your assay / laboratory performance is good enough clinically.
Specimens for Distribution 129 will be dispatched on Monday 22 June 2015, results are due back in Birmingham by, notionally, 23:59 on Sunday 12 July 2015.
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Date : DD-MMM-YYYY
Method Summary
Page 5
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
arrow median
Units Method
A score
Your Method
A scoremedian
A scoreMethod Principle All labwith trend
"units"
62
Chloride interp
Sweat Sodium
Indirect ISE [I]
66
Sweat Chloride
Indirect ISE [I]
N, I or E
105
52mmol/L
Sweat Conductivity 64
43
106
Conductivity interp
N, I or E
53
mmol/L
Wescor Macroduct [W]
68
To correctly assign you to a method we require the following pieces of information for each analyte that you measure: [1] The Manufacturer and model number of the Analyser [2] The Manufacturer and kit product/catalogue number of the reagent used specifying 'method principle', if we breakdown data by method principle [3] The Manufacturer and kit product/catalogue number of the calibrator used [4] A confirmation that you are using the 'kit' according to the manufacturer's instructions including using their calibrator values with their calibrator (if you are not using the system according to the manufacturer's instructions you will be classed as an in-house user within that method principle)
For Sweat Testing, we also need to know which collection medium, filter-paper, gauze, Micro- or Nano-duct system you are using. Until now we have not used ‘named’ manufacturers because of the variable ‘pre-analytical’ stages but we will be endeavouring to collect more information on methodologies in future.
A s
core
Graphic Equalizer Plot of A scoresAll laboratories
P-BWATSCR2
SC
L
SC
LI
SC
N
SC
NI
SN
A
SC
NID
SC
LID
0
50
100
150
200
250
300
A s
core
Method Graphic Equalizer Plot of A scoresfor your methods
P-BWATSCM2
SC
L
SC
LI
SC
N
SC
NI
SN
A
SC
NID
SC
LID
0
50
100
150
200
250
300
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Date : DD-MMM-YYYY
Cumulative Summary
Page 6
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
B s
core
C score
Sweat Chloride B score is +2.7 and C score is 2.4Your method is Indirect ISE [I] - Wescor
P-ABCPENR (ABCPENR)
0 5 10 15-15
-10
-5
0
5
10
15Your labYour methodYour method (n=37)
B s
core
C score
Sweat Conductivity B score is -0.8 and C score is 2.1Your method is Wescor Macroduct [W] - Wescor
P-ABCPENR (ABCPENR)
0 5 10 15-15
-10
-5
0
5
10
15Your labYour methodYour method (n=68)
B s
core
C score
Sweat Sodium B score is -0.4 and C score is 2.3Your method is Indirect ISE [I] - Wescor
P-ABCPENR (ABCPENR)
0 5 10 15-15
-10
-5
0
5
10
15Your labYour methodYour method (n=26)
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Date : DD-MMM-YYYY
Analyte : Sweat Chloride (mmol/L)
Page 7
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
Aqueous 30 NaCl + 10 KCl + 10 other Na salts
232
Pool description / Treatments / Additions
128B Aqueous 20 NaCl + 20 KCl + 20 other Na saltsAqueous 20 NaCl + 20 KCl + 40 other Na salts
Pool
231
Spec.
128A
128C
230 2.4
The B limit is +/-
Your B score is
The A limit is10.0
53
10.0
Your A score is+2.7
The C limit is
200
Your C score is
All methods Indirect ISE [I] Wescor
Specimen : 128A
34 37 40 43 46Sweat Chloride (mmol/L)
0
10
20
30
40
50
no. o
f lab
orat
orie
s
39.82
Coulometry [L]
39.9
Filter paper
10
Meann
40.0
3.5
Wescor
Wescor
Vitros [V]
183.1
40.1
30.0
38
3.31.5
Titration [T]
1.2
Gauze88
Colorimetry [R]
1
4.91.9
112
39.9
40.2
39.81.4
169
3
Indirect ISE [I]39.8
SD
41.3
3.7
39.9
13
2.0
3.6
Undefined [U]
3.1
1.5
CV(%)
Wescor
1
37
1.24.8
1.3
39.0
All methods [ALTM]
Weighed-in value
(ALTM)
39.9
Accuracy Index
41
40.0
Your result
48+2.9
Your specimen:
39.9
Indirect ISE [I]
Standard Uncertainty
%bias
0.1
Target value
Specimen : 128B
34 37 40 43 46Sweat Chloride (mmol/L)
0
10
20
30
40
50
60
no. o
f lab
orat
orie
s
38.32
Coulometry [L]
39.8
Filter paper
10
Meann
40.0
3.4
Wescor
Wescor
Vitros [V]
183.1
40.1
28.0
38
4.01.8
Titration [T]
1.2
Gauze88
Colorimetry [R]
1
4.21.6
112
39.8
40.2
39.91.4
169
3
Indirect ISE [I]39.9
SD
39.0
3.6
39.8
13
1.7
4.4
Undefined [U]
3.0
1.4
CV(%)
Wescor
1
37
1.24.1
1.6
39.0
All methods [ALTM]
Weighed-in value
(ALTM)
39.8
Accuracy Index
41
40.0
Your result
48+2.9
Your specimen:
Indirect ISE [I]
39.8
Standard Uncertainty
%bias
0.1
Target value
Specimen : 128C
34 37 40 43 46Sweat Chloride (mmol/L)
0
10
20
30
40
50
no. o
f lab
orat
orie
s
40.32
Coulometry [L]
40.2
Filter paper
10
Meann
40.7
3.1
Wescor
Wescor
Vitros [V]
182.8
40.6
30.0
38
3.41.6
Titration [T]
1.1
Gauze88
Colorimetry [R]
1
4.51.7
112
40.0
40.5
40.11.3
169
3
Indirect ISE [I]40.1
SD
43.4
3.3
40.0
13
1.8
4.0
Undefined [U]
2.6
1.3
CV(%)
Wescor
1
37
1.14.4
1.4
40.0
All methods [ALTM]
Weighed-in value
(ALTM)
40.0
Accuracy Index
41
40.0
Your result
35+2.1
Your specimen:
Indirect ISE [I]
40.2
Standard Uncertainty
%bias
0.1
Target value
B s
core
Median and IQRs of B scores
P-BWABCBR
All R L I
-15
-10
-5
0
5
10
15
All
Met
hod
C s
core
Median and IQRs of C scores
P-BWABCCR
All R W L F W
I
W
0
5
10
15
All Met
hod
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Pool
(exclusion)
[Type]
Distribution 123
11-Jan-2015
result target %bias
Distribution 124
08-Feb-2015
result target %bias
Distribution 125
08-Mar-2015
result target %bias
Distribution 126
12-Apr-2015
result target %bias
Distribution 127
10-May-2015
result target %bias
Distribution 128
14-Jun-2015
result target %bias
Distribution
result target %bias
22 20.3 +8.6 23 20.4 +12.7218 35 31.7 +10.4224 41 39.7 +3.2225
40 39.7 +0.7 41 40.0 +2.6219 41 39.8 +2.9231 41 39.9 +2.9230 41 40.2 +2.1232
50 49.5 +1.1229 51 49.5 +3.1226
49 49.6 -1.1 51 49.8 +2.3220 61 59.2 +3.0221
61 59.3 +2.9227 60 59.3 +1.2223 59 59.3 -0.5222
70 69.3 +1.1228
MethodmeanA scoreB scoreC score
I+2.7
22+0.4
1.2
I+1.2
26+0.6
1.5
I+1.7
33+0.9
1.7
I+5.6
41+1.4
1.8
I+5.9
51+2.3
2.7
I+2.6
53+2.7
2.4
Date : DD-MMM-YYYY
Analyte : Sweat Chloride (mmol/L)
Page 8
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
Spe
cim
en %
bias
Distribution
Specimen %biasfor each specimen in time-window
P-ABCBRS
123 124 125 126 127 128-15
-10
-5
0
5
10
15
B s
core
Distribution
B score by distributionYour current B score is +2.7
P-ABCBR
117 118 119 120 121 122 123 124 125 126 127 128-15
-10
-5
0
5
10
15
All
Met
hod
Spe
cim
en %
bias
Concentration (mmol/L)
Specimen %biasfor each specimen in time-window
P-BA1FS1P
0 10 20 30 40 50 60 70 80 90 100-15
-10
-5
0
5
10
15
C s
core
Distribution
C score by distributionYour current C score is 2.4
P-ABCCR
117 118 119 120 121 122 123 124 125 126 127 1280
5
10
15
All Met
hod
of 10
Date : DD-MMM-YYYY
Sweat Chloride mmol/L
Page 9
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
Spe
cim
en A
ccur
acy
Inde
x
Distribution
Specimen Accuracy Indexfor each specimen in time-window
P-ABCATS (ABC1)
123 124 125 126 127 1280
50
100
150
200
250
300
A s
core
Distribution
A score by distributionYour current A score is 53
P-ABCAT (ABC1)
117 118 119 120 121 122 123 124 125 126 127 1280
50
100
150
200
250
300
All M
etho
d
Spe
cim
en %
bias
Distribution
Specimen %biasfor each specimen in time-window
P-ABCBRS (ABC1)
123 124 125 126 127 128-15
-10
-5
0
5
10
15
B s
core
Distribution
B score by distributionYour current B score is +2.7
P-ABCBR (ABC1)
117 118 119 120 121 122 123 124 125 126 127 128-15
-10
-5
0
5
10
15
All
Met
hod
Diff
eren
ce (
mm
ol/L
)
Concentration (mmol/L)
Difference (result - target)for each specimen in time-window
P-BA1FS1A (ABC1)
0 10 20 30 40 50 60 70 80 90 100-12
-8
-4
0
4
8
12
C s
core
Distribution
C score by distributionYour current C score is 2.4
P-ABCCR (ABC1)
117 118 119 120 121 122 123 124 125 126 127 1280
5
10
15
All Met
hod
Spe
cim
en %
bias
Concentration (mmol/L)
Specimen %biasfor each specimen in time-window
P-BA1FS1P (ABC1)
0 10 20 30 40 50 60 70 80 90 100-15
-10
-5
0
5
10
15
B s
core
C score
Sweat Chloride B score is +2.7 and C score is 2.4Your method is Indirect ISE [I] - Wescor
P-ABCPENR (ABC1)
0 5 10 15-15
-10
-5
0
5
10
15Your labYour methodYour method (n=37)
Spe
cim
en A
ccur
acy
Inde
x
Concentration (mmol/L)
Specimen Accuracy Indexfor each specimen in time-window
P-YSTMOD (ABC1)
0 10 20 30 40 50 60 70 80 90 1000
50
100
150
200
250
300 ALTMMLTM
CV
%
Concentration (mmol/L)
Sweat Chloride Between-laboratory agreementIndirect ISE [I]
P-PROFILE (ABC1)
0 10 20 30 40 50 60 70 80 90 1000
2
4
6
8
10
12
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Interpretations
You cannot tell by measuring conductivity what the Chloride concentration is in a sweat sample (and vice versa) This is obviously also true for any other matrix.
The 3 specimens in Distribution 128 all contained 40 mmol/L of Chloride, but they contained a different amount of other compounds, such that the conductivities were approximately 50, 60 and 70 ‘units’.
It is clear that the proportion of labs interpreting the specimens as N [Not Elevated] based on conductivity decreases as we go from specimen 128A through to specimen 128C as the concentration of these other compounds increase.
The question I have posed previously is, “How does your lab interpret results on a patient on which you have obtained contradictory interpretation ‘results’ between Chloride and Conductivity?”
It doesn’t help that despite the new guidelines stating that for a 5 month old child the recommended interpretation for Chloride should have been ‘Intermediate’ for all 3 specimens, a sizeable minority considered them to be N [Not Elevated]. For example, 32 UK laboratories considered 128A to be N [Not Elevated] despite the fact that they obtained numerical values greater than 30 mmol/L.
I am putting on record that I have informed laboratories about the new guidelines, but since they are only guidelines I cannot insist that laboratories follow their advice.
Chloride Interpretation
Conductivity Interpretation
Again, just for the record, I continue to describe the units for Conductivity as ‘Units’ rather than S/m or whatever and definitely not Chloride in mmol/L nor Chloride Equivalents in mmol/L.
As ever, feedback welcome. Finlay MacKenzie, June 2015
Date : DD-MMM-YYYY Page 10
for Sweat Testing
Distribution : 128
Laboratory :
Birmingham Quality is part of the University Hospitals Birmingham NHS Foundation Trust
and provides this UK NEQAS service from PO Box 3909, Birmingham B15 2UE, UK
To contact us, email [email protected] or phone us on +44 (0)121 414 7300
© The data in this UK NEQAS report is confidential.
For this Scheme, the Organiser is Finlay MacKenzie.
www.birminghamquality.org.uk Published at 12:49 on Friday 11 March 2016
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