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Page 1: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology
Page 2: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Why do Q.A.?Why do Q.A.?

• Physician’s Expectations

• Diagnosis

• Therapy

• Technology

• Physician’s Expectations

• Diagnosis

• Therapy

• Technology

Page 3: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Physician’s ExpectationsPhysician’s Expectations

Page 4: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

DiagnosisDiagnosis

• Specificity – True Positive in Disease

• Sensitivity – True Negative

• Specificity – True Positive in Disease

• Sensitivity – True Negative

Page 5: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

TherapyTherapy

• Adjustment of Medication• Adjustment of Medication

Page 6: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

TechnologyTechnology

• Complex Instruments

• Complex Reagents

• Micro Techniques

• Complex Instruments

• Complex Reagents

• Micro Techniques

Page 7: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

What is Q.A.?What is Q.A.?

• Samples

• Control Material

• Assay Conditionsa. Reagentsb. Instruments

• Daily Review

• Retrospective Peer Review

• Samples

• Control Material

• Assay Conditionsa. Reagentsb. Instruments

• Daily Review

• Retrospective Peer Review

Page 8: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

ControlsControls

• Similar to patient samples• Respond like samples• Stability like samples

• Similar to patient samples• Respond like samples• Stability like samples

Page 9: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Daily ReviewDaily Review

• Decision Rules• Random Error• Systematic Error

• Decision Rules• Random Error• Systematic Error

Page 10: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

CalculationsCalculations

Page 11: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Gaussian DistributionGaussian Distribution

Page 12: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Abnormal DistributionAbnormal Distribution

Page 13: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Graphing – Levey-Jennings ChartsGraphing – Levey-Jennings Charts

Page 14: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

NormalNormal

Page 15: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Westgard RulesWestgard Rules

1 – 3s

2 – 2s

R – 4s

4 – 1s

10x

1 – 3s

2 – 2s

R – 4s

4 – 1s

10x

Page 16: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

1 – 3s1 – 3s

Page 17: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

2 – 2s2 – 2s

Page 18: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

2 – 2s2 – 2s

Page 19: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

R – 4sR – 4s

Page 20: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

4 – 1s4 – 1s

Page 21: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

10x10x

Page 22: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

Retrospective Peer ReviewRetrospective Peer Review

• Measurement of Peer Precision

• Method Comparisons

• Proficiency Surveys and Routine Q.C.

• Measurement of Peer Precision

• Method Comparisons

• Proficiency Surveys and Routine Q.C.

Page 23: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

SDI-Standard Deviation IndexSDI-Standard Deviation Index

Page 24: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

SDI InterpretationSDI Interpretation

• Like Signs

• Spread of 1 SDI

• Reproducibility

• Like Signs

• Spread of 1 SDI

• Reproducibility

Page 25: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

SDISDI

Page 26: Why do Q.A.? Physician’s Expectations Diagnosis Therapy Technology Physician’s Expectations Diagnosis Therapy Technology

E = mcE = mc

Excellence =Methods x Controls x Calculations

Excellence =Methods x Controls x Calculations

22


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