Imprecision remains to be improved in the measurement of serum cystatin C with heterogeneous systems.

Jie Zeng, Li Zhang, Jiangtao Zhang, Weiyan Zhou, Tianjiao Zhang, Jing Wang, Haijian Zhao, Chuanbao Zhang

Clinical chemistry and laboratory medicine 2023 Jul 26

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Except for the large bias of some measurement systems for serum cystatin C (CysC) measurements, unacceptable imprecision has been observed for the heterogenous system. This study analyzed the external quality assessment (EQA) results in 2018-2021 to provide an insight into the imprecision of CysC assays. Five EQA samples were sent to participating laboratories every year. Participants were divided into reagent/calibrator-based peer groups, for which the robust mean of each sample and robust coefficient of variation (CV) were calculated by Algorithm A from ISO 13528. Peers with more than 12 participants per year were selected for further analysis. The limit of CV was determined to be 4.85% based on clinical application requirements. The concentration-related effect on CVs was investigated using logarithmic curve fitting; the difference in medians and robust CVs between instrument-based subgroups was also evaluated. The total number of participating laboratories increased from 845 to 1,695 in four years and heterogeneous systems remained the mainstream (≥85%). Of 18 peers with ≥12 participants, those using homogeneous systems showed relatively steady and small CVs over four years, with the mean four-year CVs ranging from 3.21 to 3.68%. Some peers using heterogenous systems showed reduced CVs over four years, while 7/15 still had unacceptable CVs in 2021 (5.01-8.34%). Six peers showed larger CVs at the low or high concentrations, and some instrument-based subgroups presented greater imprecision than others. More efforts should be made to improve the imprecision of heterogeneous systems for CysC measurement. © 2023 Walter de Gruyter GmbH, Berlin/Boston.

Citation

Jie Zeng, Li Zhang, Jiangtao Zhang, Weiyan Zhou, Tianjiao Zhang, Jing Wang, Haijian Zhao, Chuanbao Zhang. Imprecision remains to be improved in the measurement of serum cystatin C with heterogeneous systems. Clinical chemistry and laboratory medicine. 2023 Jul 26;61(8):1455-1462