To figure out exactly when to use single rule or multirule QC procedures, you will need to define the quality required for each test, look at the precision and accuracy being achieved by your method, then assess the probabilities for false rejection (P fr) and error detection (P ed) of the different candidate QC procedures. Earlier generation automated systems and manual methods will often benefit from the improved error detection of multirule QC procedures. In general, you will find that single rule QC procedures are adequate for your highly automated and very precise chemistry and hematology analyzers, but you should avoid using 2s control limits or the 1 2scontrol rule to minimize waste and reduce costs. If 90% error detection can not be provided by a single rule QC procedure, then a multirule QC procedure should be considered. If medically important errorscan be detected 90% of the time (i.e., probability of error detection of 0.90 or greater), then a single rule QC procedure is adequate. The remaining issue is whether adequate error detection can be provided by these other single rule QC procedures. This generally means eliminating the 1 2s rule because of its high false rejections and considering others such as 1 2.5s, 1 3s, and 1 3.5s which have acceptably low false rejection rates. Not always! Sometimes a single rule QC procedure gives you all the error detection needed while at the same time maintaining low false rejections.
When should you use a multirule QC procedure?
Multirule QC is the general approach for doing this. Strategies with multiple tests can also be used to optimize the performance of a QC procedure.
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