rcpaqap chemical pathology review of activities

RCPAQAPQChemical PathologyReview of ActivitiesGraham JonesChairChairRCPAQAP Chemical Pathology

2013 in Focus3

RCPAQAP Chemical Pathology

2013 New Programs/AnalytesPrograms

3 g / y

• Liquid Serum Chemistry• Reference Interval Survey• PoCT Chemistry (formerly Near Patient Testing)Analytes• Urine ACR in the Urine Chemistry Program (previously PoCT

ACR – insufficient participants to continue)• Gastrin in the Tumour Marker Program

• moved from the Endocrine Program on the advice of the E d i W ki P tEndocrine Working Party

2013 Participants2013 Participants

6000

4000

5000

3000

2000

0

1000

198

198

198

198

198

198

198

198

199

199

199

199

199

199

199

199

199

199

200

200

200

200

200

200

200

200

200

200

201

201

201

201

48 countries7 Continents82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13

No.of Programs No. of Participants

7 Continents27 % non‐Australasian

New ‐ Korea

2013 Participants % Region2013 Participants - % RegionMiddle East 4 4North South America, 0.1 Melanesia, 0.5

Asia 14 1

Europe, 1.6Africa, 3.6

Middle East, 4.4North America, 0.8 Indian Subcontinent, 1.5

Asia, 14.1

Australasia, 73.5

2013 Growth2013 Growth6000

5000 6417 programs5.4% increase

3000

4000

1900 participants

2000

3000 1900 participants7.6% increase

1000

0 1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

2012


No.of Programs No. of Participants

2013 Enrolments2013 Enrolments

810

910Program Participants

610

710

8 0

s

410

510

Participan

ts

210

310

No. of

‐90

10

110

AlcohBasic Bile ABloodBloodBNPCondCSF CCSF OEndocEndocEndocEndocFOBGeneGlycoGlycoIGF‐1Liqui dNeonOn Si

PatiePlasmPoCT PoCT PorphPorphPorphPorphSpeciSpeciSpeciSpeciSw

eaTraceTraceTraceTum

oUrineUrineUrineUrineVitamVitamVitam

90 hol /Ammonia

Serum Chem

ist rAcidsd Gasesd Gases ‐ CO

‐oxim

ensed General CChem

istryOligoclonal Bandscrinecrine (PSA)crine (ACE)crine (RCF)

ral Serum Chem

iohaem

oglobin ‐ Lohaem

oglobin ‐ W/ C Peptided Serum

Chemist

natal Bilirubinte Toxicologynt Report Com

mma M

etanephrineChem

istryTroponinhyrins ‐ Bloodhyrins ‐ Faeceshyrins ‐ Plasm

ahyrins ‐ Urineal Drugsal Drugs ‐ Antibioal Drugs ‐ Im

mun

al Lipidsat Electrolytese Elem

ents ‐ Serue Elem

ents ‐ Urin

e Elements ‐ Bloo

our Markers

e Chemistry ‐ Bas

e Chemistry ‐ Biog

e Pregnancy Testie Toxicologymins

min B1/B6

min C

ry metry

hemistry

s istryLyophilisedWhole Blood

try entses oticsnosuppressants

um e od sic genic Amines

ing

Commutable EQA MaterialQ

• Most RCPAQAP material lyophilised and adjusted• Advantages for analyte range, stability & distribution• The material has not been verified as commutable• The material has not been verified as commutable• CPQAP is introducing patient samples to complement th l hili d lthe lyophilised samples• Fresh Whole Blood HbA1c• Liquid Serum Chemistry

• Gives participants information of the accuracy of theirGives participants information of the accuracy of their method compared to other methods


Liquid Serum ChemistryLiquid Serum Chemistry• 2 specimens of fresh frozen sera; 120 participants2 specimens of fresh frozen sera; 120 participants• 1st time CPQAP has sourced & distributed fresh frozen sera• Challenges• Challenges• Sera

• Volunteers, volume & collection timing• Sourcing the sera – agreements in place• Last minute crisis• Immunology QAP to the rescue!Immunology QAP to the rescue!

• Aliquotting & distribution thanks to ASE• Kristina will discuss laterRCPAQAP Chemical Pathology

• Kristina will discuss later

Bias 2 Studyy

• Conducted by Gus Koerbin on behalf of AACB Harmonisation Project

• Patient samples and EQA samples distributed to different platforms

• Primary aim • to establish whether the common instrument platforms give similar patient results to establish common reference intervals

• Supplementary aim• To assess commutability of EQA material across different platforms and compare with patient sera


• Jan will discuss later

Reference Interval Surveyy• An element of the AACB Harmonisation Project• Baseline survey to establish what RI currently used• Participants supplied their lab RIs for a 40 year old male for

General Chemistry analytes• Used by AACB Harmonisation Workshop in July• Pilot survey

• sent out with the Liquid Serum Chemistry Program• Future

• annual survey• expand participants• expand ranges of analytes


expand ranges of analytes• Kristina will discuss later

Contracted ProgramsgQAAMS• Quality Assurance for Aboriginal & Torres Strait Aboriginal• Quality Assurance for Aboriginal & Torres Strait Aboriginal

Medical Services• PoCT HbA1c & Urine ACR to monitor Aborigines with diabetes• PoCT HbA1c & Urine ACR to monitor Aborigines with diabetes• Managed by Flinders University International Centre for PoCT

& RCPAQAP& RCPAQAP• Funded by Department of Health & Aging• New 2013 – 2016 contractNew 2013 2016 contractGlucose Meters EQA• Abbott MediPro• Abbott MediPro• Roche Solutions• AMSL StatStrip


AMSL StatStrip• Covers over 4000 meters

myQAPyQ• Participant Portal• Online enrolmentsOnline enrolments• Tracking invoices• pdf reports• pdf reports• Enrolment Certificate• Communicating with QAPs• Communicating with QAPs

Chemical Pathology QAP WebsiteChemical Pathology QAP Website• Result entry• Viewing reports• Viewing reports• Previous reports

D t b h


• Database search

Electronic ReportspExisting

/ h h• www.rcpaqap.com.au/chempath• Single analyte/page

Addi i l f• Additional features • eg all programs & analytes

d t b filt• database filterNew

l i df• Electronic pdf reports• pdf file of paper report

M l i l l• Multiple analytes• Access through myQAP


• www.myqap.com.au

E‐mail notification

• See the booth for a demonstration

2014 in Focus4

2014 Enrolment Changes4 g• myQAP enrolment• Programs with multiple modules – Pricing restructure

• eg Blood Gases & CO‐oximetry• Previously – combined modules with discounted price• 2014 – purchase Blood Gases and CO‐oximetry individually

See staff at Booth for further information


2014 The End of Paper4 p• No paper reports• No folders, satchels or spines (shhhh… contact the QAP

Office)• Result, Correction & Method Classification Sheets not

being sent with paperwork• Participants encouraged to enter results electronically• If not able to enter results on website

• pdf copies of Result Correction & Method Classification Sheets available on website to download or from QAP Office, for faxing



ff f f f

New/Changes in 2014 Programs• PoCT Blood Gases

f Abb tt iSTAT Al• for Abbott iSTAT or Alere epoc• optimised material; haemoglobin, haematocrit & total CO dd dCO2 added

• Abbott i‐STAT currently enrolled in BG or PoCT Chem. fto transfer

• Endocrine <10 analytes• General Urine Chemistry <5 analytes (no longer Basic)• Special Drugs & Antibiotics – combined – Special Drugs

Program

RCPAQAP Chemical PathologySee staff at Booth for further information

New/Changes in 2014 Programs• PoCT Chemistry – additional analytes added

Li id S Ch i t l l t d l dd d• Liquid Serum Chemistry – calculated values added• anion gap, corrected Ca, eGFR, osmolar gap

• Urine Toxicology – creatinine added• General Serum Chemistry T3 no longer offered• Reminder

• Roche Cardiac Reader – enrol in General Chemistryoc e Ca d ac eade e o Ge e a C e st y• Roche h232 – enrol in PoCT Troponin



Trace Elements 20144• Joining a federation of countries – The Netherlands, France,

Spain Belgium Italy New York state in a combined TE programSpain, Belgium, Italy, New York state in a combined TE program• Occupational & Environmental Laboratory Medicine Trace

Element Program (OELM)• all using the same material and entering results at the same

time, with the generation of electronic reports • Badged as RCPAQAP• Badged as RCPAQAP• OELM Reports online 5‐10 days after closing date• RCPAQAP Interim Reports will also be producedRCPAQAP Interim Reports will also be produced• Annual meeting of participating countries to discuss changes• Advantages: ‐ increased peer groupg p g p

‐ additional analytes• Countries joining to offer the specialised EQAS is the way forward

d i hi i h QMPLS (T C d ) i h E d i & PSA


• doing this with QMPLS (Toronto, Canada) with Endocrine & PSA

2014 New Pricing Structure2014 New Pricing Structure20.0

0 0

10.0

‐10.0

0.0 Alcohol /Ammon

Basic Serum Che

Bile AcidsBlood G

asesCO

‐oximetry

BNP

Condensed Che mCondensed ChemCondensed ChemCondensed ChemCondensed ChemCSF Chem

istryCSF O

BsEndocrineEndocrine PSAEndocrine ACEEndocrine RCFFaecal O

ccult Bl oGeneral Chem

isGeneral Chem

isGeneral Chem

isGeneral Chem

isGeneral Chem

isLiquid Serum

ChGlycohaem

oglobGlycohaem

oglobIGF‐1/ C Peptide

Neonatal Bilirub

Patient Report CPlasm

a Metanep

PoCT TroponinPoCT Chem

istry PoCT Chem

istry Porphyrins Plas mPorphyrin U

rinePorphyrin Bloo dPorphyrin FaeceSpecial DrugsIm

munosuppre s

Special LipidsSw

eat Electroly tTrace Elem

ents Trace Elem

ents Trace Elem

ents Tum

our Marker

Urine Chem

istr yUrine Biogenic A

Urine Pregnancy

Urine Toxicology

On‐site U

rine ToVitam

ins Plasma

Vitamin Blood

Vitamin C

‐20.0

niaem

istry

mistry > 40 Analyt

mistry 31‐40 Analy



mistry <10 Analyte

oodstry > 40 Analytesstry 31‐40 Analytesstry 21‐30 Analytesstry 11‐20 Analytesstry <10 Analyteshem

istrybin Lyophilisedbin W

hole Bloode binCom

ments

phrines

11‐20 Analytes <10 Analytesma

d es ssants

tes ‐ Serum‐ U

rine‐ W

hole Bloods y GeneralAm

inesy Testingy oxicology Screeninga

% Cha

nge

‐30.0

tesytesytesyteses s s s g%

‐50.0

‐40.0

‐60.0

Thanks toAACB W ki P tiAACB Working Parties

• CPQAP provides 45 different EQAS which cover the vast majority of biochemistry analytes

• Not possible without the specialist knowledge and assistance of the AACB Working Parties

• 130 members give approximately 1000 hours of their time l t ilvoluntarily

• Accuracy and Standardisation PorphyrinsAll bl Li i f P f S i l D• Allowable Limits of Performance Special Drugs

• Biogenic Amines Sweat Electrolytesl• CSF Trace Elements

• Endocrine Urine Toxicology


• HbA1c Vitamins

rcpaqap chemical pathology review of activities

Documents