EXTERNAL QUALITY ASSESSMENT
but explanatory way, that they are able to utilise to identify, correct and/or mitigate errors to ensure an accurate result. We also may provide information on best techniques or methodologies that other laboratories are using to support review of their internal processes to enhance their quality. We support and educate the laboratories, using the appropriate specialist experts in that field, to get them back on track or to ensure they start off in the best possible place. Periodically, there may be a clear need for EQA but the practicalities of delivering it are greater than first realised. Chantell is leading the team that is delivering a Digital Pathology EQA. This pioneering new way to deliver EQA utilises the whole-slide images (WSI) which are digitally captured in each laboratory. The EQA is essential to ensure that the digital representation of the physical slide is the same as the image of the physical slide viewed through a microscope, to ensure accurate diagnosis. The benefits are clear, but the delivery of the Digital Pathology EQA has taken time to work through. Issues such as governance, data collection and confidentiality, need to be considered and resolved, as well as the technology needed to handle the EQA requirements. Even something seemingly as simple as file formats have generated much discussion as different laboratories utilising different equipment from differing manufacturers globally, are saved in different file formats. An EQA scheme needs to be able to ‘assess’ each image in its original format, as any conversion could, in itself, alter the digital representation of that physical slide, therefore any feedback from the EQA could be inaccurate. We are pleased to report that solutions have been found for many of these elements and the Digital Pathology EQA will be launched in the near future. It is a great example of how the skills and knowledge of a wide range of experts are needed to develop a pragmatic and beneficial EQA.
Testing, testing!
Prior to launching a new EQA, we survey the laboratories to ascertain the benefits to their participants, to discover how they will use it, and what percentage of a particular population they will be testing. We also ask what type of samples they need and/or utilise – particularly for pharma genomic testing for drug reactivity, where we work with laboratories around the world. Different environmental factors can affect the test results and different laboratories use different sample types – we need to be aware of this if we are to run successful EQA.
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Running a pilot before a new EQA is available to a wider audience ensures that it meets the same standards of an accredited EQA, as well as allowing time for review and revision.
The survey is repeated after the first year to see how the EQA may be improved or further tailored to meet their needs.
In addition, we always run a pilot
before a new EQA is available to a wider audience. This ensures that the new EQA meets the same standards of an accredited EQA and gives us time to review and revise the EQA to ensure it is fit-for-purpose. The outcome of the pilot may mean that the EQA is revised, it proceeds, or it may be withdrawn. Once launched, the EQA process does not stop there. All UK NEQAS EQA are constantly monitored and extensively reviewed as guidelines, technology and knowledge changes. For example additional genes or variants may now be recommended for a particular genetic test, so the EQA will be updated to reflect these changes. As processes and knowledge changes, we need to flex the EQA to reflect this and as much as we can, future proof the EQA to ensure it keeps abreast of working practices. Developing EQA is a complex process but one that a broad range of experts take time over to ensure that the work will support laboratories, the diagnostic process, and patients.
Innovative EQA to deliver better outcomes for patients We spend an often-unquantifiable amount of time discussing, developing and revising programmes to ensure that we deliver the very best EQA possible. We are conscious that sometimes laboratories believe that the EQA is designed to catch them out and no
matter how clearly we believe we have articulated the EQA criteria, it can be misinterpreted. This is where education goes hand-in-hand with developing EQA. Whether it’s just guidance and support through results, or expert webinars, masterclasses, e-learning… this list goes on.
We work hard to deliver the optimum,
clearest EQA that guides laboratories to always deliver the right test results for each patient, in a timely manner. This is why we regularly monitor our EQA and develop new EQA. It’s for the patients. Purely and simply, so that all centres globally are consistently providing the highest quality tests meeting patient needs.
Becky Treacy, Deputy Director for Genomics Quality Assessment (GenQA) Chantell Hodgson, Scheme Director for UK NEQAS Cellular Pathology Technique (CPT)
About UK NEQAS
UK NEQAS is a charitable consortium of external quality assessment providers. It aims to improve patient care through monitoring the quality of tests and their reporting, in an independent manner and on a not-for-profit basis. The primary role of UK NEQAS is educational. It is committed to supporting a culture of continuous quality improvement within UK NEQAS and among its partners and participants. UK NEQAS provides an appropriate, responsive and high standard of EQA to clinical laboratories.
+44 (0)114 261 1689
centraloffice@ukneqas.org www.ukneqas.org.uk
DECEMBER 2024
WWW.PATHOLOGYINPRACTICE.COM
AdobeTsock / MP Studio
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