Update on methods used for mycological testing: wide diversity and opportunities for improvement persist.

Past analysis of laboratory methods used for mycology specimens revealed significant variation in practices, many of which fell short of recommended procedures. In 2016 these findings led to a set of recommendations for laboratories to consider modification of their methods where appropriate, to analyse current laboratory methods used by participants in the Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) Mycology module, and to compare these to the 2016 recommendations. Seven test items, with 105-107 participants each, were analysed.

The European Organisation of External Quality Assurance Providers in Laboratory Medicine (EQALM) Statement: guidelines for publishing about interlaboratory comparison studies (PubILC).

Data and results from interlaboratory comparison (ILC) studies, external quality assessment (EQA) and proficiency testing (PT) activities are important and valuable contributions both to the further development of all disciplines of medical laboratory diagnostics, and to the evaluation and comparison of diagnostic assays. So far, however, there are no recommendations as to which essential items should be addressed in publications on interlaboratory comparisons. The European Organization of External Quality Assurance Providers in Laboratory Medicine (EQALM) recognized the need for such recommendations, and these were developed by a group of experts.

Blood culture quality assurance: findings from a RCPAQAP Key Incident Monitoring and Management Systems (KIMMS) audit of blood culture performance.

Blood cultures (BC) are the gold standard investigation for bloodstream infection. Standards exist for BC quality assurance, but key quality indicators are seldom measured. The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) Key Incident Monitoring and Management Systems (KIMMS) invited laboratories for the first time to participate in an audit to determine adult BC positivity rates, contamination rates, sample fill volumes and the proportion received as a single set.

Validation of a commercial line blot for the detection of serum anti-Ro60 autoantibodies.

Serum anti-Ro60 is one the most frequently encountered autoantibodies in the diagnostic immunopathology laboratory and in clinical practice. A large variety of assays are available to detect this including the popular multiplex line immunoblot (IB) assay. We evaluated the analytical performance of the IB for anti-Ro60 detection, using the counterimmunoelectrophoresis (CIEP) method as the 'gold standard'.

Improving Youden plots by including analytical performance specifications.

Historically, Youden plots are made of a scatter plot of the results of two EQA samples with an elliptical confidence area around them. Because Youden plots compare individual laboratory results with respect to other laboratories, they intrinsically evaluate with state of the art. In the field of medical laboratory science, analytical performance specifications have been proposed and various EQA providers show these limits on Youden plots by horizontal and vertical lines near the limits of total error.

Rapid On-Site Evaluation Technical Exercise Using Digital Pathology: Peer Comparison in an External Quality Assurance Setting.

Background: The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) is a world leader in the provision of external quality assurance (EQA) for pathology laboratories. The development and delivery of new programmes are designed to meet the evolving needs of our participants and pathology practice. A cytopathology technical programme was established in 2018 to provide proficiency testing in routine cytopreparatory techniques.

Attitudes of Australasian Clinicians and Laboratory Staff to Changing Fungal Nomenclature: Has Mycological Correctness Really Gone Mad?

Fungal nomenclature changes have been a regular occurrence in recent years, eliciting heated debate on whether such changes will confuse clinicians and harm patients. We conducted surveys of Australasian laboratory staff and clinicians to assess attitudes, practices, and concerns regarding nomenclatural change. The majority of respondents to both surveys were aware of fungal nomenclatural changes (93.

A framework for evaluating the frequency of external quality assessment challenges.

Background And Aims: No clear rules about the optimal frequency of organizing External Quality Assessment (EQA) rounds exist. More frequent challenges will facilitate faster responses and more reliable statistics. Adding extra samples leads to extra information, but the correlation between results from different samples reduces the extra information from additional samples.

Harmonization status of procalcitonin measurements: what do comparison studies and EQA schemes tell us?

Sepsis represents a global health priority because of its high mortality and morbidity. The key to improving prognosis remains an early diagnosis to initiate appropriate antibiotic treatment. Procalcitonin (PCT) is a recognized biomarker for the early indication of bacterial infections and a valuable tool to guide and individualize antibiotic treatment.

Blood culture quality assurance: what Australasian laboratories are measuring and opportunities for improvement.

Blood cultures are among the most important specimen types received and processed by the microbiology laboratory. Several publications list which variables should be measured to ensure quality. We undertook a qualitative structured questionnaire of Australian and New Zealand clinical microbiology laboratories to document current blood culture practices and to determine whether expected quality standards are being met.

Laboratory quality assessment of candidate gene panel testing for acute myeloid leukaemia: a joint ALLG / RCPAQAP initiative.

Accurate classification of acute myeloid leukaemia (AML) has become increasingly reliant on molecular characterisation of this blood cancer. Throughout Australia and New Zealand massively parallel sequencing (MPS) is being adopted by diagnostic laboratories for the routine evaluation of patients with AML. This technology enables the surveying of many genes simultaneously, with many technical advantages over single gene testing approaches.

Changes in error rates in the Australian key incident monitoring and management system program.

Introduction: The Key incident monitoring and management system program (KIMMS) program collects data for 19 quality indicators (QIs) from Australian medical laboratories. This paper aims to review the data submitted to see whether the number of errors with a higher risk priority number (RPN) have been reduced in preference to those with a lower RPN, and to calculate the cost of these errors.

Materials And Methods: Data for QIs from 60 laboratories collected through the KIMMS program from 2015 until 2018 were retrospectively reviewed.

Paraprotein Sample Exchange in Australia and New Zealand - 2018.

Quantification of co-migrating paraproteins in the beta-region presents an ongoing challenge for laboratories performing serum protein electrophoresis. The between-laboratory variation may impact patient care if the patient uses different pathology services during plasma cell dyscrasia monitoring. To identify the practical difficulties and determine the extent of agreement in the reporting of beta-migrating paraproteins in Australia and New Zealand (NZ), sample exchanges were conducted in five Australian states and in NZ in early 2018.

Report of the Survey Conducted by RCPAQAP on Current Practice for Paraprotein and Serum Free Light Chain Measurement and Reporting: a Need for Harmonisation.

Clinical laboratory testing is vital in the diagnosis, monitoring and prognostication of monoclonal gammopathies. Although the 2012 recommendations for standardised reporting of protein electrophoresis in Australia and New Zealand aimed to harmonise the laboratory practices related to paraprotein testing, the between-laboratory variation still exists. A survey was conducted to assess the between-laboratory variation in certain aspects of laboratory testing related to monoclonal gammopathy.

The RCPA Quality Assurance Program in Dermatopathology: A Retrospective Review.

Aims: To review the Royal College of Pathologists of Australasia (RCPA) Quality Assurance Program Dermatopathology module from 2005 to 2016 to assess diagnostic performance, changes over time, and areas of diagnostic difficulty.

Methods: The computerized records of the RCPA Dermatopathology subspecialist module were reviewed. Cases were categorized into groups including nonneoplastic disorders, neoplasms, and cases with multiple diagnoses.