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Westgardrules
The Westgard rules are a set of statistical patterns, each being unlikely to occur by random variability,
thereby raising a suspicion of faulty accuracy or precision o

f the measurement system. They are used for laboratory quality control, in "runs" consisting of measurements
of multiple samples. They are a set of modified Western Electric rules, developed by James Westgard and
provided in his books and seminars on quality control.They are plotted on Levey–Jennings charts, wherein the
X-axis shows each individual sample, and the Y-axis shows how much each one differs from the mean in terms
of standard deviation (SD). The rules are:

Rule Criteria Suspected Example ACCEPTED/

REJECTED

Inaccuracy and /or

12s One measurement exceeds 2
imprecision WARNING
standard deviations either above or
below the mean of the reference
range.

Inaccuracy and/or
13s One measurement exceeds 3 imprecision REJECTED
standard deviations either above or
below the mean of the reference
range.

2 consecutive measurements
Inaccuracy and/or
22s exceed 2standard deviations of the
imprecision REJECTED
reference range, and on the same
side of the mean.

Two measurements in the same run

have a 4 standard deviation
difference (such as one exceeding 2
R4s standard deviations above the Imprecision. REJECTED
mean,and another exceeding 2
standard deviations below the
mean).

4 consecutive measurements
41s exceed 1 standard deviation on the Inaccuracy. REJECTED
same side of the mean.

10x 10 consecutive measurements are

Inaccuracy. REJECTED
on the same side of the mean.

https://en.wikipedia.org/wiki/Westgard_rules 1/2
 References
1. Ofer Harel; Enrique F. Schisterman;Albert Vexler & Marcus D. Ruopp (July 2008). "Monitoring
QualityControl:CanWeGetBetterData?"(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625303).
Epidemiology.19(4):621.doi:10.1097/ede.0b013e318176bfb2(https://doi.org/10.1097%2Fede.0b0
13e318176bfb2).PMC2625303(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625303).PMID
18496467 (https://pubmed.ncbi.nlm.nih.gov/18496467).
2. HeidiHanes."WestgardRules-Guidelines"(http://resources.psmile.org/resources/process-
control/quality-control/Pro5.0-10%20Guidelines%20to%20Westgard%20Rules%20.doc). SMILE,
Johns Hopkins University. Review date: 1 April 2020

https://en.wikipedia.org/wiki/Westgard_rules 2/2