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SMILE Accuracy Guidelines-Chemistry: Author
SMILE Accuracy Guidelines-Chemistry: Author
SMILE Comments: This document is provided as an example only. It must be revised to accurately reflect your lab’s
specific processes and/or specific protocol requirements. Users are directed to countercheck facts when considering
their use in other applications. If you have any questions contact your SMILE representative.
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476105914.doc 1 of 9 30-Apr-09
SMILE Chemistry Accuracy Flowchart
Determine your comparison or
reference method
Evaluate data
following step III.
A in attached
guideline
No
Collect additional data
R >0.975?
over larger range
Yes
Yes
Accuracy experiment
Evaluate data following step
FAILS. Troubleshoot
III. D. 6 in attached guideline
before repeating accuracy
(Six Sigma)
studies
Accuracy experiment
Accuracy experiment FAILS. Troubleshoot
PASSES before repeating accuracy
studies
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SMILE Chemistry Accuracy Guidelines
ACCURACY is the true value of a substance being measured. Verification of accuracy is the
process of determining that the test system is producing true, valid results.
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A. Plot the data in a regression analysis
program or spreadsheet. The SMILE A. Plot the data in EP Evaluator Two
Accuracy Pack is included for this use Instrument Comparison Module or a similar
(Appendix 1). regression analysis program.
1. Plot the reference method on the X axis 1. Plot the reference method on the X axis
and the method being validated on the Y and the method being validated on the Y
axis. axis.
2. Enter the Allowable Total Error (TEa) 2. Enter the Allowable Total Error (TEa)
concentration and percent. Refer to concentration and percent. Refer to
SMILE Chemistry TE Limits table. SMILE Chemistry TE Limits table.
(Appendix 2) (Appendix 2)
3. Enter the results for the reference (X) 3. Enter the results for the reference (X)
and the new (Y) methods. and the new (Y) methods.
4. Evaluate the statistics. 4. Evaluate the statistics by clicking on Print
5. The correlation coefficient (R) must be Preview or on the statistics tab.
>0.975 5. The correlation coefficient (R) must be
>0.975
If Then
R <0.975 Data does not extend over acceptable range.
More data must be evaluated over larger range.
R >0.975 Proceed with step B below to evaluate acceptability.
B. Using this method, 95% of the data points from the comparative method must be
within Total Allowable Error limit of the reference method (refer to SMILE
Chemistry TE Limits table, Appendix 2). Use one of the methods below to
evaluate.
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1. Using a regression analysis program or 1. The EP Evaluator program uses a statistic
spreadsheet (such as the SMILE Accuracy called the “Error Index” to measure the
Pack, Appendix 1) calculate the “Error difference between the two methods as a
Index” to measure the difference between ratio of the Total Allowable Error.
the two methods as a ratio of the Total a. The Error Index can be calculated by
Allowable Error. subtracting the reference method data
a. The Error Index can be calculated by point (X) from the method being validated
subtracting the reference method data data point (Y) and dividing by the Total
point (X) from the method being validated Allowable Error (TEa). The equation is:
data point (Y) and dividing by the Total (Y-X)/TEa.
Allowable Error (TEa). The equation is: b. EP Evaluator uses the percent TEa or
(Y-X)/TEa. the minimum detectable difference
b. Use the percent TEa or the minimum (absolute TEa), whichever is greater.
detectable difference (absolute TEa), c. The absolute TEa value is calculated by
whichever is greater. converting the TEa percentage to a
c. The absolute TEa value is calculated by decimal and multiplying by the reference
converting the TEa percentage to a method data point.
decimal and multiplying by the reference d. The Error Index is measured for each X-
method data point. Y pair, and must fall within -1 and 1. If
d. The Error Index is measured for each X- more than 5% of the specimens have an
Y pair, and must fall within -1 and 1. If Error Index of less than -1 or greater than
more than 5% of the specimens have an 1, the accuracy experiment fails. (See
Error Index of less than -1 or greater than Appendix 3 for an example EP report).
1, the accuracy experiment fails.
If Then
95% of Error Indices Accuracy is acceptable
are acceptable Proceed with Linearity experiments
D. Plot the data in a regression analysis program such as the SMILE Accuracy
Pack (Appendix 1) or EP Evaluator Alternate (Quantitative) Method
Comparison module. Deming Regression is preferred, however if not
available regular regression is acceptable provided that the Correlation
Coefficient (R) is >0.975.
1. Plot the reference method on the X axis and the method being validated
on the Y axis.
2. Enter the Allowable Total Error (TEa) concentration and percent. Refer to
SMILE Chemistry TE Limits table (Appendix 2).
3. Enter Medical Decision Points
i. A Medical Decision Point (MDP) is the concentration of the analyte at
which a medical decision is triggered. You may enter up to five values.
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These values are plotted on the graph, and the program computes a
predicted Y value and confidence interval at each X decision point.
ii. For many analytes, the medical decision points correspond to the
lower and upper limits of the normal range. It is advisable to also
include medical decision points at the DAIDS Toxicity limits and/or
laboratory established critical values.
4. Evaluate using one of the methods described below:
If Then
All error indices fall Proceed with step 6 below.
between -1 and 1
Any error indices fall Consider possible causes of inaccuracy.
outside -1 and 1 Troubleshoot before repeating accuracy studies.
Consult SMILE for assistance.
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i. If using EP Evaluator, use the Deming Regression slope and
intercept calculated by the program.
ii. If EP Evaluator is not used, it is acceptable to use slope and intercept
calculated using regular regression.
e. Enter the Means and %CVs from your Between Day Precision
experiments.
i. If using EP Evaluator create the report by selecting the Print Preview
button. (See Appendix 6 for an example EP report).
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ii. The SMILE Accuracy Pack and EP Evaluator calculate a Sigma
metric for each Medical Decision point.
iii. Sigma metric=(TEa-Systematic Error)/Random Error
f. Evaluate acceptability at each MDP using the table below:
If Then
The Sigma The method has unacceptable performance and does not meet
metric less your requirement for quality, even when the method is working
than 2.0 properly.
It is not acceptable for routine operation.
The Sigma The method has marginal performance and provides the
metric is necessary quality when everything is working correctly.
between 2.0- This method will require:
3.0 o 4-8 controls per run
o well-trained operators
o reduced rotation of personnel
o more aggressive preventive maintenance
o careful monitoring of patient test results
o continual efforts to improve method performance
If the Sigma The method has fair performance and meets your requirement for
metric is quality and can be well-managed in routine operation.
between 3.0- This method will require 2 control measurements per run using
4.0 standard Westgard QC rules.
If the Sigma The method has good performance and is clearly acceptable and
metric is can be well-managed in routine operation with only 2 control
between 4.0- measurements per run using standard Westgard QC rules.
6.0
If the Sigma The method has Six Sigma performance and is even easier to
metric is >6.0 manage and control.
IV. References
A. GCLP Workshop and Workbook18-20 May 2008, Verification of Performance
Specifications, pages 1-33.
B. Clinical and Laboratory Standards Institute (CLSI). User Verification of
Performance for Precision and Trueness: Approved Guideline-Second Edition.
CLSI document EP15-A2 (ISBN 1-56238-574-7). Clinical and Laboratory
Standards Institutes, 940 West Valley Road, Suite 100, Wayne, Pennsylvania
19098-1898 USA, 2005.
C. NCCLS. (Currently CLSI) Evaluation of Precision Performance of Quantitative
Measurement Methods; Approved Guideline—Second Edition. NCCLS document
EP5-A2 (ISBN 1-56238-542-9). NCCLS, 940 West Valley Road, Suite 1400,
Wayne, Pennsylvania 19087-1898 USA, 2004.
D. Clinical and Laboratory Standards Institute (CLSI). Method Comparison and Bias
Estimation Using Patient Samples: approved Guidelines- Second Edition. CLSI
document EP9-A2 (ISBN 1-56238-472-4). Clinical and Laboratory Standards
Institutes, 940 West Valley Road, Suite 100, Wayne, Pennsylvania 19098-1898
USA, 2005.
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E. Clinical and Laboratory Standards Institute (CLSI).Preliminary Evaluation of
Quantitative Clinical Laboratory Measurement Procedure: Approved Guidline –
Third Edition. CLSI document EP10-A3 (ISBN 1-56238-622-0). ). Clinical and
Laboratory Standards Institutes, 940 West Valley Road, Suite 100, Wayne,
Pennsylvania 19098-1898 USA, 2005.
F. Clinical and Laboratory Standards Institute (CLSI).Estimation of Total analytical
Error for Clinical Laboratory Methods. Approved 2003. CLSI document EP21-A
(ISBN 1-56238-502-xX. Clinical and Laboratory Standards Institutes, 940 West
Valley Road, Suite 100, Wayne, Pennsylvania 19098-1898 USA, 2005.
G. EP Evaluator Release 8, David G. Rhoads Associates Inc., www.dgrhoads.com.
H. James O. Westgard, Online Validation Training, Westgard QC, Inc.
www.westgard.com, Sections 11-Determining Bias,12- Estimating Trueness, and
13- Judging Method Acceptability.
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