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Establishing an External Quality Assessment (EQA) Program for Urinalysis in Medical Laboratories of Thailand

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Abstract

Thailand Association of Clinical Biochemists (TACB) introduced External Quality Assurance schemes (EQAs) for urinalysis (UA) using urine strips in medical laboratories of Thailand. The few available External Quality Assessment (EQA) programs on urinary microalbumin rarely include an evaluation of clinical cases. The aim of the present study was to assess a descriptive analysis of biochemical urinalysis including urine microalbumin in the Thailand laboratory practice. From January 2021 to December 2021, four surveys were organized. EQA urine samples were distributed to the participants by mail. The participants measured the UA of 2 samples quarterly and returned the results together with the information about their instruments and suggestion for the performance of the laboratory report quarterly. Moreover, summary of the situation of each laboratory performance was feedbacked by online system. Fifty-eight laboratories participated in the survey. The EQA panels included positive and negative samples. The analytical results for passed parameters of urine chemical test range from 79.3–100%. All special tests; microalbumin, creatinine, and beta-HCG showed correct result from 85.1–96.1%. The overall accuracy, specificity, and sensitivity were 92.6, 85.7, and 75,4%, respectively. The major issues were observed: the low sensitivity for the detection of low-concentration samples and the incapacity of several methods to detect the positive sample. The assessment is needed to continuously evaluate the improvement proficiency of laboratories in Thailand.

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References

  1. Fogazzi GB, Garigali G. The clinical art and science of urine microscopy. Curr Opin Nephrol Hypertens. 2013;12:625–32. https://doi.org/10.1097/00041552-200311000-00009.

    Article  Google Scholar 

  2. Verdesca S, Brambilla C, Garigali G, Croci MD, Messa P, Fogazzi GB. How a skillful and motivated urinary sediment examination can save the kidneys. Nephrol Dial Transplant. 2017;22:1778–81. https://doi.org/10.1093/ndt/gfm142.

    Article  Google Scholar 

  3. Huussen J, Koene RAP, Hilbrands LB. The (fixed) urinary sediment, a simple and useful diagnostic tool in patients with haematuria. Neth J Med. 2014;62:4–9.

    Google Scholar 

  4. Györy AZ, Kesson AM, Talbot JM. Microscopy of urine –now you see it, now you don’t! Am Heart J. 1999;99:537–8. https://doi.org/10.1016/0002-8703(80)90391-9.

    Article  Google Scholar 

  5. Chien TI, Kao JT, Liu HL, Lin PC, Hong JS, Hsieh HP, et al. Urine sediment examination: a comparison of automated urinalysis systems and manual microscopy. Clin Chim Acta. 2007;384:28–34. https://doi.org/10.1016/j.cca.2007.05.012.

    Article  CAS  PubMed  Google Scholar 

  6. Secchiero S, Fogazzi GB, Manoni F, Epifani MG, Plebani M. The italian external quality assessment (EQA) program on urinary sediment by microscopy examination: a 20 years journey. Clin Chem Lab Med. 2020;59:845–56. https://doi.org/10.1515/cclm-2020-1656.

    Article  CAS  PubMed  Google Scholar 

  7. Delanghe J, Speeckaert M. Preanalytical requirements of urinalysis. Biochem Med (Zagreb). 2014;59:89–104.

    Article  Google Scholar 

  8. Libeer JC, Baadenhuijsen H, Fraser CG, Petersen PH, Ricos C, Stöckl D, et al. Characterization and classification of external quality assessment schemes (EQA) according to objectives such as evaluation of method and participants bias and standard deviation. Eur J Clin Chem Clin Biochem. 1996;34:665–78.

    CAS  PubMed  Google Scholar 

  9. Stavelin A, Petersen PH, Sølvik UØ, Sandberg S. External quality assessment of point-of-care methods: model for combined assessment of method bias and single-participant performance by the use of native patient samples and noncommutable control materials. Clin Chem. 2013;59:363–71. https://doi.org/10.1373/clinchem.2012.191957.

    Article  CAS  PubMed  Google Scholar 

  10. Pidetcha P, Fongsupa S, Bordeerat NK, Dansethakul P, Rungpanitch U. Proceedings: 15th asia-pacific federation for clinical biochemistry and laboratory medicine (APFCB) congress 2019, Jaipur. India Ind J Clin Biochem. 2019;34:185.

    Google Scholar 

  11. Wald R, Bell CM, Nisenbaum R, Perrone S, Liangos O, Laupacis A, et al. Interobserver reliability of urine sediment interpretation. Clin J Am Soc Nephrol. 2009;4:567–71. https://doi.org/10.2215/CJN.05331008.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ottiger C, Huber AR. Quantitative urine particle analysis: integrative approach for the optimal combination of automation with UF-100 and microscopic review with KOVA cell chamber. Clin Chem. 2003;49:617–23. https://doi.org/10.1373/49.4.617.

    Article  CAS  PubMed  Google Scholar 

  13. Cho J, Oh KJ, Jeon BC, Lee SG, Kim JH. Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment. Clin Chem Lab Med. 2019;57:1744–53. https://doi.org/10.1515/cclm-2019-0211.

    Article  CAS  PubMed  Google Scholar 

  14. Mayo S, Acevedo D, Quiñones-Torello C, Canós I, Sancho S. Clinical laboratory automated urinalysis: comparison among automated microscopy, flow cytometry, two test strips analyzers and manual microscopic examination of the urine sediments. J Clin Lab Anal. 2008;22:262–70. https://doi.org/10.1002/jcla.20257.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kouri TT, Gant VA, Fogazzi GB, Hofmann W, Hallander HO, Guder WG. Towards European urinalysis guidelines. Introduction of a project under European confederation of laboratory medicine. Clin Chim Acta. 2000;297:305–11. https://doi.org/10.1016/s0009-8981(00)00256-4.

    Article  CAS  PubMed  Google Scholar 

  16. Fogazzi GB, Secchiero S, Consonni D, Sciacovelli L, Zardo L, Garigali G, et al. An italian external quality assessment (EQA) program on urinary sediment. Clin Chim Acta. 2010;411:859–67. https://doi.org/10.1016/j.cca.2010.02.073.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the part of financial support provided by Thammasat University under the Thammasat University Research Unit in Developing of Quality Control Materials for Medical Laboratory. In addition, the data of this study was extracted from External Quality Assurance schemes (EQAs) for urinalysis (UA) by the Thailand Association of Clinical Biochemists (TACB).

Funding

The corresponding author has received partial financial support from the Thammasat University Research Unit in Developing of Quality Control Materials for Medical Laboratory.

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Authors and Affiliations

  1. Department of Medical Technology, Faculty of Allied Health Science, Thammasat University, Pathumthani, 12120, Thailand

    N. K. Bordeerat & S. Fongsupa

  2. Thailand Association of Clinical Biochemists (TACB), Bangkok, 10700, Thailand

    N. K. Bordeerat, S. Fongsupa, P. Dansethakul & P. Pidetcha

  3. Department of Immunology, Faculty of Siriraj Medicine Hospital, Bangkok, Thailand

    U. Rungpanitch

  4. Academic and Community Health Development Service Adviser, Faculty of Medical Technology, Mahidol University, Bangkok, 10700, Thailand

    P. Pidetcha

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  1. N. K. Bordeerat
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  2. S. Fongsupa
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  3. P. Dansethakul
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  4. U. Rungpanitch
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  5. P. Pidetcha
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Correspondence to N. K. Bordeerat.

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Conflict of interest

All Authors are on the board of directors of Thailand Association of Clinical Biochemists (TACB) and receives no compensation as member of the board of directors.

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Ethical approval was waived by the Human Research Ethics Committee of Thammasat University (Science) in view of the retrospective nature of the study and all the procedures being performed were part of routine care.

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Bordeerat, N.K., Fongsupa, S., Dansethakul, P. et al. Establishing an External Quality Assessment (EQA) Program for Urinalysis in Medical Laboratories of Thailand. Ind J Clin Biochem 39, 271–275 (2024). https://doi.org/10.1007/s12291-022-01102-3

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  • DOI: https://doi.org/10.1007/s12291-022-01102-3

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