By Sten Westgard, MS
While Dr. Westgard has spoken about the "War of Words" between Uncertainty and Total Error in several essays (here, here and here most recently), we thought readers might want an additional perspective on the issue.
Dietmar Stockl, an expert in statistics and laboratory quality control from across the Atlantic, graces us with an guest essay on the calculation, use, benefits and limitations of measurement uncertainty: Time to Engage in Measurement Uncertainty. Dr. Stockl provides an in-depth look at uncertainty concepts and calculations, as well as a moderate viewpoint on the use of the term. He views both Total Error and Measurement Uncertainty are useful concepts and believes there is room in the world for both of them. It's not necessary for one term to eliminate the other.
Not so coincidentally, a colleague of Dr. Stockl's, Linda Thienpont, has a letter in Clinical Chemistry talking about the attempt to incorporate bias into the calculation of measurement uncertainty. If bias can be thrown into the uncertainty calculations, a case could be made that Total Error is no longer necessary. Dr. Thienpont points out that slipping bias into the uncertainty calculations is not a good idea and can lead to distorted results. She concludes that bias must remain separate from uncertainty calculations, which means another approach like Total Error is required to account for it.
See more at Thienpont LM. Calculation of measurement uncertainty-Why bias should be treated separately. Clin Chem 2008;54:1587 (subscription required) -----
What's New this month at Westgard Web:
Posted by Sten Westgard
One of the highlights for me of the AACC convention in Washington, DC, was my inclusion in a poster that analyzed the method performance of the Abbott Architect c8000. I'm pictured here with fellow authors (left to right) Gene Osikowicz, Charles Wilson, and John Baker (lead author). They deserve most of the credit for the work of collecting the data.
The poster can be viewed here and the QC application on Westgard Web can be viewed here. -----
New Download: Sigma-Metrics Tool (and audioconference presentation)
On September 4th, 2008, Dr. Westgard spoke as part of the AACC audioconference on "New Directions in Laboratory QC" - which was subsequently quoted in the Clin Lab News article on Risk and CLIA. We are pleased to make available Dr. Westgard's complete presentation, as well as two Sigma-metrics Charts and instructions on how to use them in QC Design.
Westgard Sigma Analysis: A new direct HbA1c Method
At the 2008 AACC/ASCLS convention, a poster was presented for a new direct enzymatic assay for %HbA1c. How does it stack up against HPLC and immunoassay methods? How do you judge a method when you've got multiple comparison methods and multiple quality requirements?
Interview: Dr. R. Neill Carey (A brief introduction to EP 15)
We were fortunate to get R. Neill Carey, PhD, the chair of the CLSI EP 15 committee, to present and
explain that new standard at the Chicago Method Validation workshop. He also contributed a chapter to the new Basic Method Validation manual on the same topic. But for those who have never heard of EP 15 before, we conducted a short interview with Dr. Carey. This short introduction to EP 15 may pique your interest in this new guideline.
Thinking about Three Sigma: 2 thoughts on troublesome performance
In a previous lesson, we discussed some possible actions to take when the Sigma-metric for a method is higher than Six. But what about those methods with low Sigma-metrics? What do you do when Sigma analysis delivers bad news?
Posted by Sten Westgard
This month, Dr. Westgard was teaching his spring semester class for the University of Wisconsin Medical Technology school. He likes to use recently published papers in the scientific literature as a way to relate his lessons to things happening in the "real world" of the laboratory.
This semester, he has written up a number of lessons covering HbA1c methods, performance, and quality requirements based on the article in Clinical Chemistry, Few Point-of-Care Hemoglobin A1c Assay Methods Meet Clinical Needs, by David E. Bruns1 and James C. Boyd and a study by Lenters-Westra and Slingerland (Six out of eight hemoglobin A1c point-of care instruments do not meet the generally accepted analytical performance criteria. Clin Chem 2010;56:44 –52.)
For your convenience, here are the lessons in order...
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