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Analytical Performance Evaluation of a Clinical Microbiology Laboratory Using Sigma Metrics

Yıl 2025, Cilt: 15 Sayı: 1, 1 - 5

Öz

Aim: Six sigma is a quality metric for performance evaluation and comparison. It can be used as a guide in determining internal quality control (IQC) strategies and frequency. In our study, we aimed to perform analytical performance evaluation using six sigma method for frequently used test parameters in microbiology laboratory.
Material and Method: A six-month analysis was conducted on quality control data for HBsAg, Anti-HCV, and Anti-HIV tests. The Sigma metrics were calculated for the parameters tested on the Roche Cobas 601 autoanalyzer. The quality goal index (QGI) was calculated to identify the reason for analytes with low sigma values.
Results: The sigma metrics demonstrated varied performance across the tests. The HBsAg test sigma values ranged from 2.0 to 8.8, generally remaining within an acceptable range (≥3). The Anti-HIV test yielded mixed results, with some sigma values dropping below the acceptable threshold in certain months, indicating the necessity for periodic review and adjustment. In contrast, the Anti-HCV test demonstrated a consistently low sigma value (average 2.84). When the average sigma value was calculated over a six-month period, Anti-HCV was the only analyte with a sigma value less than 3 and considered unacceptable.
Conclusion: Our findings demonstrate the necessity of continuous monitoring, staff training, and rigorous quality control measures. By addressing the specific issues identified through Sigma metrics, we can achieve higher standards of accuracy and precision, which ultimately contributes to improved healthcare quality.

Etik Beyan

The study was conducted with the approval of the Clinical Research Ethics Committee at Afyonkarahisar Health Sciences University (Decision: 2023/194).

Destekleyen Kurum

None

Teşekkür

We deeply appreciate the staff of the Microbiology laboratory at AFSU for their unreserved support.

Kaynakça

  • 1. Chauhan K P, Patel J D, Trivedi A, Six sigma in clinical biochemistry: It matters, measure it. Int J Clin Biochem Res 2017;4(3):270-274
  • 2. International Organization for Standardization (ISO). ISO/IEC 17025. General requirements for the competence of testing and calibration of laboratories, 2005
  • 3. Mao X, Shao J, Zhang B, Wang Y. Evaluating analytical quality in clinical biochemistry laboratory using Six Sigma. Biochem Med (Zagreb). 2018;28(2):020904.
  • 4. Westgard S, Westgard QC. Six Sigma metric analysis for analytical testing processes. Abbott MS. 2009;9:04. 5. Yadav R, Bhartiya JP, Verma SK, Nandkeoliar MK. External quality assessment scheme (EQAS): Our experience as a participating laboratory. IJRRMS. 2013;3(4):1-4.
  • 6. Wang RY. Beyond accuracy: what data quality means to data consumers. J Manag Inf Syst. 1996. https://doi.org/10.1080/ 07421222.1996.11518099.
  • 7. Plebani M, Sciacovelli L, Aita A, Padoan A, Chiozza ML. Quality indicators to detect pre-analytical errors in laboratory testing. Clin Chim Acta. 2014;432:44-48.
  • 8. Nar R, Emekli DI. The Evaluation of Analytical Performance of Immunoassay Tests by using Six-sigma Method. J Med Biochem. 2017;36(4):301-308
  • 9. Nevalainen D, Berte L, Kraft C, Leigh E, Picaso L, Morgan T. Evaluating laboratory performance on quality indicators with the six sigma scale. Arch Pathol Lab Med. 2000;124(4):516-519.
  • 10. Hens K, Berth M, Armbruster D, Westgard S. Sigma metrics used to assess analytical quality of clinical chemistry assays: importance of the allowable total error (TEa) target. Clin Chem Lab Med. 2014;52(7):973-980.
  • 11. Zhou B, Wu Y, He H, Li C, Tan L, Cao Y. Practical application of Six Sigma management in analytical biochemistry processes in clinical settings. J Clin Lab Anal. 2020;34(1):e23126.
  • 12. Sharma LK, Datta RR, Sharma N (2020) Evaluation of Sigma Metrics of Commonly Assayed Biochemical Parameters in a Clinical Laboratory. J Clin Chem Lab Med. 3.142. DOI: 10.35248/clinical-chemistry-laboratory-medicine.20.3.142
  • 13. Aggarwal K, Patra S, Acharya V, Mahapatra SK. Application of Six sigma metrics and Method decision charts in improvising clinical Chemistry laboratory performance enhancement. Int J Adv Med 2019;6:1524-30.
  • 14. Zhang C, Zhao H, Wang J, Zeng J, Wang Z. The Application of Six Sigma Techniques in the Evaluation of Enzyme Measurement Procedures in China. Clin Lab. 2015;61(5-6):461-465.
  • 15. Tran MT, Hoang K, Greaves RF. Practical application of biological variation and Sigma metrics quality models to evaluate 20 chemistry analytes on the Beckman Coulter AU680. Clin Biochem. 2016;49(16-17):1259-1266.
  • 16. Korkmaz, S.2022. Sigma metric evaluation with different TEa targets in clinical biochemistry. DOI: 10.14744/ijmb.2022.81300 Int J Med Biochem 2022;5(2):120-124.
  • 17. Thomas V, Desai P. B, Mithrason A. T. Evaluation of clinical biochemistry laboratory performance using sigma metrics. Int J Clin Biochem Res. 2018;5(4):604-607.
  • 18. Yücel Ç, Ercan M, Kızılgün M. The evaluation of analytical performance of Total PSA and Free PSA tests by using 6-sigma method Turk Hij Den Biyol Derg, 2021;78(2):153-158.
  • 19. Dundar B, Halipci Topsakal H.N. Evaluation of analytical performance of tests worked on the same brand devices wıth six sigma metrics. Turk J Clin Lab 2023; 2: 321-329.

Sigma Metriklerini Kullanarak Bir Klinik Mikrobiyoloji Laboratuvarının Analitik Performansının Değerlendirilmesi

Yıl 2025, Cilt: 15 Sayı: 1, 1 - 5

Öz

Amaç: Altı sigma, performans değerlendirmesi ve karşılaştırması için bir kalite ölçütüdür. İç kalite kontrol (İKK) stratejilerinin ve sıklığının belirlenmesinde bir rehber olarak kullanılabilir. Çalışmamızda, mikrobiyoloji laboratuvarında sık kullanılan test parametreleri için altı sigma yöntemini kullanarak analitik performans değerlendirmesi yapmayı amaçladık.
Gereç ve Yöntem: HBsAg, Anti-HCV ve Anti-HIV testleri için kalite kontrol verileri üzerinden altı aylık bir analiz yapılmıştır. Roche Cobas 601 otoanalizöründe test edilen parametreler için Sigma metrikleri hesaplanmıştır. Düşük sigma değerlerine sahip analitlerin nedenini belirlemek için kalite hedef indeksi (QGI) hesaplanmıştır.
Bulgular: Sigma metrikleri testler arasında farklı performans göstermiştir. HBsAg testi sigma değerleri 2,0 ila 8,8 arasında değişmiş ve genellikle kabul edilebilir bir aralıkta (≥3) kalmıştır. Anti-HIV testi karışık sonuçlar vermiş, bazı sigma değerleri belirli aylarda kabul edilebilir eşiğin altına düşerek periyodik inceleme ve ayarlama gerekliliğine işaret etmiştir. Buna karşılık, Anti-HCV testi sürekli olarak düşük bir sigma değeri göstermiştir (ortalama 2,84). Altı aylık bir dönem boyunca ortalama sigma değeri hesaplandığında, Anti-HCV sigma değeri 3'ün altında olan ve kabul edilemez olarak değerlendirilen tek analit olmuştur.
Sonuç: Bulgularımız sürekli izleme, personel eğitimi ve titiz kalite kontrol önlemlerinin gerekliliğini ortaya koymaktadır. Sigma ölçümleri aracılığıyla belirlenen spesifik sorunları ele alarak, daha yüksek doğruluk ve kesinlik standartlarına ulaşabiliriz ve bu da sonuçta sağlık hizmetlerinin kalitesinin artmasına katkıda bulunur.

Kaynakça

  • 1. Chauhan K P, Patel J D, Trivedi A, Six sigma in clinical biochemistry: It matters, measure it. Int J Clin Biochem Res 2017;4(3):270-274
  • 2. International Organization for Standardization (ISO). ISO/IEC 17025. General requirements for the competence of testing and calibration of laboratories, 2005
  • 3. Mao X, Shao J, Zhang B, Wang Y. Evaluating analytical quality in clinical biochemistry laboratory using Six Sigma. Biochem Med (Zagreb). 2018;28(2):020904.
  • 4. Westgard S, Westgard QC. Six Sigma metric analysis for analytical testing processes. Abbott MS. 2009;9:04. 5. Yadav R, Bhartiya JP, Verma SK, Nandkeoliar MK. External quality assessment scheme (EQAS): Our experience as a participating laboratory. IJRRMS. 2013;3(4):1-4.
  • 6. Wang RY. Beyond accuracy: what data quality means to data consumers. J Manag Inf Syst. 1996. https://doi.org/10.1080/ 07421222.1996.11518099.
  • 7. Plebani M, Sciacovelli L, Aita A, Padoan A, Chiozza ML. Quality indicators to detect pre-analytical errors in laboratory testing. Clin Chim Acta. 2014;432:44-48.
  • 8. Nar R, Emekli DI. The Evaluation of Analytical Performance of Immunoassay Tests by using Six-sigma Method. J Med Biochem. 2017;36(4):301-308
  • 9. Nevalainen D, Berte L, Kraft C, Leigh E, Picaso L, Morgan T. Evaluating laboratory performance on quality indicators with the six sigma scale. Arch Pathol Lab Med. 2000;124(4):516-519.
  • 10. Hens K, Berth M, Armbruster D, Westgard S. Sigma metrics used to assess analytical quality of clinical chemistry assays: importance of the allowable total error (TEa) target. Clin Chem Lab Med. 2014;52(7):973-980.
  • 11. Zhou B, Wu Y, He H, Li C, Tan L, Cao Y. Practical application of Six Sigma management in analytical biochemistry processes in clinical settings. J Clin Lab Anal. 2020;34(1):e23126.
  • 12. Sharma LK, Datta RR, Sharma N (2020) Evaluation of Sigma Metrics of Commonly Assayed Biochemical Parameters in a Clinical Laboratory. J Clin Chem Lab Med. 3.142. DOI: 10.35248/clinical-chemistry-laboratory-medicine.20.3.142
  • 13. Aggarwal K, Patra S, Acharya V, Mahapatra SK. Application of Six sigma metrics and Method decision charts in improvising clinical Chemistry laboratory performance enhancement. Int J Adv Med 2019;6:1524-30.
  • 14. Zhang C, Zhao H, Wang J, Zeng J, Wang Z. The Application of Six Sigma Techniques in the Evaluation of Enzyme Measurement Procedures in China. Clin Lab. 2015;61(5-6):461-465.
  • 15. Tran MT, Hoang K, Greaves RF. Practical application of biological variation and Sigma metrics quality models to evaluate 20 chemistry analytes on the Beckman Coulter AU680. Clin Biochem. 2016;49(16-17):1259-1266.
  • 16. Korkmaz, S.2022. Sigma metric evaluation with different TEa targets in clinical biochemistry. DOI: 10.14744/ijmb.2022.81300 Int J Med Biochem 2022;5(2):120-124.
  • 17. Thomas V, Desai P. B, Mithrason A. T. Evaluation of clinical biochemistry laboratory performance using sigma metrics. Int J Clin Biochem Res. 2018;5(4):604-607.
  • 18. Yücel Ç, Ercan M, Kızılgün M. The evaluation of analytical performance of Total PSA and Free PSA tests by using 6-sigma method Turk Hij Den Biyol Derg, 2021;78(2):153-158.
  • 19. Dundar B, Halipci Topsakal H.N. Evaluation of analytical performance of tests worked on the same brand devices wıth six sigma metrics. Turk J Clin Lab 2023; 2: 321-329.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Mikrobiyoloji
Bölüm Orjinal Araştırma
Yazarlar

Melahat Gürbüz 0000-0001-6290-1216

Yayımlanma Tarihi
Gönderilme Tarihi 31 Temmuz 2024
Kabul Tarihi 16 Aralık 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 15 Sayı: 1

Kaynak Göster

AMA Gürbüz M. Analytical Performance Evaluation of a Clinical Microbiology Laboratory Using Sigma Metrics. J Contemp Med. 15(1):1-5.