[Six Sigma driven QC management in hepatitis C serology].

Mohamed Mokhtar Khelil
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Abstract

The Westgard quality control (QC) rules are often applied in infectious diseases serology to validate the quality of results, but this requires a reasonable tradeoff between maximum sensitivity to errors and minimum false rejections. This article, in addition to illustrate the six sigma methodology in the QC management of the (anti-HCV Architect®) test, it discusses the main influencing factors on sigma value. Data from low positive and in-kit control materials spreading over 6 months and using four reagent kits, were used to calculate the precision of the test. The difference between the control material reactivity and the cut-off defined the error budget. Sigma values were > 6, which indicates that the method produces four erroneous results per million tests. The application of the six sigma concept made it possible to argue the choice of the new QC strategy (use of 13S rule with one positive control) and to relax the existing QC rules. This work provides a framework for infectious diseases serology laboratories to evaluate tests performances against a quality requirement and design an optimal QC strategy.

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[六西格玛驱动的丙型肝炎血清学质量控制管理]。
韦斯特加德质量控制(QC)规则通常应用于传染病血清学中,以验证结果的质量,但这需要在最大的错误敏感性和最小的错误拒绝之间进行合理权衡。本文除了说明六西格玛方法在(抗-HCV Architect®)检验质量控制管理中的应用外,还讨论了影响西格玛值的主要因素。使用四种试剂盒,从 6 个月的低阳性对照材料和试剂盒内对照材料中获得的数据被用来计算检验的精确度。对照材料反应性与临界值之间的差值定义了误差预算。西格玛值大于 6,表明该方法每百万次测试会产生四个错误结果。六西格玛概念的应用使得选择新的质量控制策略(使用 13S 规则和一个阳性对照)和放宽现有的质量控制规则成为可能。这项工作为传染病血清学实验室提供了一个框架,使其能够根据质量要求评估检测结果,并设计出最佳的质量控制策略。
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