Norwegian X values

NORIP

Test of trueness of measurement systems used in Denmark, Iceland and Norway by use of NFKK Reference Serum X.

As an aid to test measurement system trueness before implementing NORIP reference intervals into the lab, NFKK Reference serum X (see certificate) have been produced together with a spreadsheet to facilitate the calculations to estimate local bias.

NFKK Reference Serum X is sent to the laboratory on dry ice.

The plots show % deviation from target for NFKK Reference serum X:

Measurement system (with laboratory code behind) are shown on X-axis and % bias on Y axis. Data are sorted first on measurement system, then on uncorrected (see below) X means.
Filled quadrats (blue: Denmark, black: Iceland and Norway, red: producer's reference lab) for uncorrected X means (the black lines between the quadrats is intended to visually keep the labs using the same measurement system together).
Open black quadrats for corrected X mean. "Corrected" means that laboratory's reference standard (calibrator) run in parallell with X have been used to correct mean of measured X values by multiplication with the factor: target value of calibrator divided by the mean of measurement values for the calibrator. Some labs have not measured the calibrator and therefore the open black square is missing for those laboratories.
The quality goal for bias (0.375 x total biological variation) is shown as red solid horisontal lines.
The 2 x standard uncertainty (95% confidence) of target value of X is shown as blue dotted lines

Comments are only made where bias is significant relative to bias goal.

Each laboratory have their own lab code behind measurement system label on X-axis. Contact Pål Rustad (prustad#furst.no) to get your lab code.

Updated 25/5-2005		Evaluation for Norway
Component	Target value for X	General comments	Abbott, Aeroset/Architect	Bayer, Advia 1650	Dade Behring, Dimension (1 lab)	Roche Cobas Integra	Roche Hitachi (and Modular)	Ortho (Vitros)
Albumin Norway, Iceland Denmark, Iceland and Norway	41.5 g/L	In brackets behind instrument on X-axis is given method: P for brom cresol purple (BCP) and G for brom cresol green (BCG). Uncertainty of X target value greater than quality goal	Aeroset (BCG) 20% high	~4% high	~2% high	6-13% high	~5% high (3-10%)	~2% high (0-5%)
Bilirubin Norway, Iceland Denmark, Iceland and Norway	8.97 µmol/L	Low value: Limited interest	Aeroset ~60% high	~30% high, great dispersion (10-40%)	Good	Good	Good	~0-30% low
Phosphate Norway, Iceland Denmark, Iceland and Norway	1.043 mmol/L		~5% low (but two labs good uncorrected values)	~3-4% low, but within bias goal	4% low	Good	Very good	Good
Glucose Norway, Iceland Denmark, Iceland and Norway	4.405 mmol/L	Generally high, but within goal	Good	Great dispersion, 2-8% high	5% high	Great dispersion (-6% to +6%)	Half of labs excellent, rest ~4% high	0-8% high
HDL-cholesterol Norway, Iceland Denmark, Iceland and Norway	1.387 mmol/L	Consensus target value: mean from NORIP	Good	Good	10% high	~5% low	Good	Good
Iron Norway, Iceland Denmark, Iceland and Norway	20.0 µmol/L		~ 14% low	~ 12% low	~ 10% low	Very good	Very good	~ 8% low
Potassium Norway, Iceland Denmark, Iceland and Norway	3.732 mmol/L	Generally very good	Architect ~ 3% low	Good	2% low	Good	Good corrected	Good uncorrected
Calcium Norway, Iceland Denmark, Iceland and Norway	2.325 mmol/L	Great dispersion relative to goal	Architect 2-8% low	Great dispersion: 3 on -5% and 3 from -2% to +1%	~ 5% low	3-5% high	~2% high (0-5%)	~ 2% low
Cholesterol Norway, Iceland Denmark, Iceland and Norway	5.22	Generally ~2% high	Good uncorrected, corrected ~2%high	2-3% high	Good	Great dispersion (-6 to 10%)	Good corrected	1-4% high
Creatinine Norway, Iceland Denmark, Iceland and Norway	73.9 µmol/L	E or J in brackets behind measurement system on X-axis indicates enzymatic or Jaffe method respectively. Roche generally correct, others too high	~6% high	~25% high				~12% high
Magnesium Norway, Iceland Denmark, Iceland and Norway	0.810 mmol/L		~20% high	Good	~5% low	~5% high	1/2 of labs above goal (2.6%)	Good
Sodium Norway, Iceland Denmark, Iceland and Norway	140.65 mmol/L	Narrow goal (0.5%). Clearly better corrected values are better. Generally a little bit low	Good	Great dispersion, OK corrected.	~2% low	Great dispersion (-5% to +0.5%)	Corrected (-1% to +1%) much better than uncorrected which are -4.5% to 1%	-1% to +2%
Protein Norway, Iceland Denmark, Iceland and Norway	68.7 g/L		Good	~2% high	Good	Good	0-4% high	0-5% high
TIBC Norway	68.9 µmol/L	Consensus target value: mean from NORIP. Good agreement for all						Only one lab: Uncorrected 7 % high
Triglycerides Norway, Iceland Denmark, Iceland and Norway	1.287 mmol/L	Generally above target (~4%), but well within goal
Urea Norway, Iceland Denmark, Iceland and Norway	4.910 mmol/L	Generally high for all except Cobas Integra and Vitros, but within goal except some Abbot and Bayer	Aeroset ~8 % high	4-10 % high, mean 7 %	6% high	Good	Mean 4% high	Good
Uric acid Norway, Iceland Denmark, Iceland and Norway	309.9 µmol/L	Generally good	7-8 % low	Very good	~7 % low	-9% to +2%	Very good	Very good
Enzymes
ALP Norway	72.5 U/L	Consensus target value. All well within goal
ALAT Norway, Iceland	24.2 U/L	Low value, limited interest. Generally high means (~10%), but within goal except most Vitros.						-10% to 50%
Amylase Norway, Iceland Denmark, Iceland and Norway	60.7 U/L	Consensus target value. Generally good except some Vitros						Low 0 to 35%
Amylase, pancreatic Norway, Iceland	28.6 U/L	Consensus target value. All very good.
ASAT Norway, Iceland	25.5 U/L	Consensus target value. Low value, limited interest.	5-25 % low	-5% to +10%	OK	1/2 of labs ~15% high	6 of 11 is 10-20 % high	Good
CK Norway, Iceland Denmark, Iceland and Norway	133.3 U/L	All well within goal, but generally 5-10% low
GT Norway, Iceland Denmark, Iceland and Norway	35.42 U/L	Low value. Generally 5-10% low.	Good (low)	10-20 % low	Good (low)	5-15 % low	5-10 % low	-10% to +4%
LD Norway, Iceland (different scale) Denmark, Iceland and Norway	147.8 U/L	Consensus target value. High values according to old level (before IFCC rec. method)		Dispersion: 15% low to 5% high				Two extreme values, i.e. original Vitros data!