Towards Accurate Results for Patient Care

Laboratory medicine results influence a high percentage of all clinical decisions. Patients and doctors expect that different laboratories, using different methods, will give the same result for an analyte measured in a clinical sample. Often this is not the case and an inappropriate clinical decision for a patient may be the consequence. Globalization compounds the issue as study results and clinical practice guideline recommendations are used without consideration of the method being used.

Traceability in laboratory medicine (TLM) aims to reduce between method variability so that results are independent of time or location. Application of the metrological traceability chain facilitates a universal approach based around the preparation, adoption and use of higher order international commutable reference materials and reference measurement procedures, supported by expert reference laboratories. Global collaboration is required, involving several different stakeholder groups ranging from international experts to laboratory medicine specialists in routine clinical laboratories [1].

The IFCC is a founder member of the Joint Committee for Traceability in Laboratory Medicine (JCTLM), which:

• maintains a freely available global database of commutable reference materials, reference measurement procedures and reference laboratories (bipm.org/jctlm/).
• provides freely available resources and educational materials to help others understand and promote TLM (jctlm.org).

Recently the IFCC Working Group on Commutability published three linked articles that provide the definitive study of commutability. These articles should help to ensure both reference materials and control materials will behave in a similar way to patient samples across a range of methods. A special report written by Greg Miller and Neil Greenberg summarises these three articles. It may be accessed at: http://www.jctlm.org/media/1110/commutability-special-report-april-2018.pdf

1. Beastall GH, Brouwer N, Quiroga S, Myers GL. Traceability in laboratory medicine: a global driver for accurate results for patient care. Clin Chem Lab Med 2017; 55: 1100-1108. https://doi.org/10.1515/cclm-2017-0060