EXTERNAL QUALITY ASSESSMENT integral to all EQA.”
UK NEQAS’ standing worldwide enables its scientists to connect with manufacturers and provide evidence and data when commercial tests may not be working as expected. For example, UK NEQAS for H&I discovered a specific manufacturers’ coeliac disease genetic test product instructions were misleading. We were able to contact the manufacturer with the EQA evidence, as well as reporting concerns to the MHRA, which resulted in the instructions being changed. Thanks to the expertise and longevity of data sets, UK NEQAS has also been able to produce guidelines that standardise how coeliac disease genetic test results should be interpreted – almost a beginners guide to reading the results!
With community testers not having the same levels of expertise, alongside different report formats used by different methods/analysers, the need for UK NEQAS to monitor and support testing in the community is clear.
implication but even more importantly, it had a detrimental effect on the wellbeing of the patient. In this case, when the test was redone at their regular laboratory, the result range was back to the expected level but it clearly illustrates how patients react to their results. “It’s first-hand proof that patients do not know that different laboratories can use different methodology and analysers which can affect test results, and underlines why EQA has to ensure consistency.”
“Everything we do is for the patients”
As we see healthcare moving further towards a ‘point-of-care’ model, EQA becomes even more important to ensure that community diagnostic hubs deliver similar optimum levels of testing to that delivered by the centralised and established laboratories. Often, community testers do not have the same levels of expertise, alongside which, different report formats are commonly used by different methods/analysers. The need for UK NEQAS to monitor and support, share expertise, and streamline processes, is clear - patients are the reason for EQA, and education is at the heart of EQA. As we all work hard to speed up the flow of patients through the system, the drive for accuracy and continuous improvement is vital. Gwen explains: “When I discover out of consensus results, for example as I
did recently for copper and zinc levels, I write to the laboratories concerned to offer advice based on my experience. We work together to learn what is preventing accurate testing, and I always reiterate that what we are doing is not to criticise the laboratory but to improve patient safety. I know that everyone repeats this but it is our strong partnership with laboratories that is making a tangible difference.”
As well as accuracy, UK NEQAS is also focused on the important interpretive comments that accompany the test results. These comments help to ensure that clinical teams interpret the results correctly so that the patient benefits from the correct diagnosis. When these comments differ between laboratories or particularly if they are unclear, there is the risk that they will be misinterpreted and patients wrongly diagnosed or treated Gwen expands on this: “The
Birmingham centre runs an educational interpretive comments programme that assesses comments submitted for a clinical case scenario with laboratory results. Each interpretative comment is scored and the reports contain information on low-, medium- and high- scoring comments, as well as information on the outcome of the case. Other UK NEQAS programmes offer interpretative comments exercises on a more ad hoc basis. This is part of the ‘added value’ delivered by UK NEQAS but to be honest, interpreting comments should be
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Patients are the reason for EQA UK NEQAS gives users the confidence that they are providing the best results for their assays and clinical teams and patients the reassurance that they are receiving the correct information. Our expert knowledge of new technologies allows the early implementation of EQAs for groundbreaking testing, and we collaborate with manufacturers and regulatory agencies to ensure the effective resolution of problems with assays, analysers and kits.
Sharing our expertise, working closely with laboratories to ensure continuous improvement, and reducing variations between laboratories are all critical activities to ensure that results are trusted by both clinicians and patients. We are unashamedly proud of our EQA and all that it encompasses and at the end of the day, we are all working with the same goal – for the benefit of the patient.
Dr Deborah Pritchard, Director for UK NEQAS for Histocompatibility and Immunogenetics Dr Gwen Wark, Scheme Director, UK NEQAS Guildford Peptide Hormones and Trace Elements
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
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