Rethinking IVD Quality Control: A Two-Component IQC Model Tied to Clinical Performance Specs
This review proposes a redesigned quality surveillance framework for in vitro diagnostic devices, splitting internal quality control into two components: manufacturer-supplied materials with unbiased targets for traceability verification, and laboratory-driven monitoring linked to analytical performance specifications and measurement uncertainty. The model also calls for external quality assessment programs using commutable materials with reference-procedure-assigned values. The framework aims to bridge the gap between IVD regulation and real-world clinical suitability of test results.
The original study
Redesigning the surveillance of
- Authors
- Panteghini M
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 36542481
Original abstract
IVD manufacturers have total responsibility in terms of the traceability of marketed in vitro diagnostic medical devices (IVD-MD). This includes the provision of a quality control (QC) material as a part of the measuring system, suitable for traceability verification and alignment surveillance by end-users in daily practice. This material [to be used for the internal QC (IQC) component I as described in this paper] should have unbiased target values and an acceptability range corresponding to analytical performance specifications (APS) for suitable (expanded) measurement uncertainty (MU) on clinical samples. On the other hand, medical laboratories (by the IQC component II as described in this paper) should improve the IQC process and its judging criteria to establish a direct link between their performance, estimated as MU of provided results, and APS defined according to recommended models to apply corrective actions if the performance is worsening with the risk to jeopardize the clinical validity of test results. The participation to external quality assessment (EQA) programs that meet specific metrological criteria is also central to the evaluation of performance of IVD-MDs and of medical laboratories in terms of harmonization and clinical suitability of their measurements. In addition to the use of commutable materials, in this type of EQA it is necessary to assign values to them with selected reference procedures and to define and apply maximum allowable APS to substantiate the suitability of laboratory measurements in the clinical setting.