Guest Essay
Dr. Carmen Ricos provides us with a comprehensive database of biologic variation for over 300 quantities, based on a review of over 140 articles in the scientific literature. The accompanying database includes the observed between- and within-subject biologic variation for these quantities, as well as desirable specifications for imprecision, bias and total allowable error. This is a fantastic wealth of information for those seeking more guidance on quality requirements.
Diana Mass, from Arizona State University, shares her thoughts on how the continuing success of laboratories may have contributed to their downfall. As laboratories continue to do "more with less" management seems to expect them to do even more with even less. What can labs do to prevent this downward spiral? Diana has a few remedies.
Dr. Callum Fraser is recognized as the international expert on biologic variation. His new book from the AACC press: Biologic Variation: Principles and Practice is now the definitive reference on the subject. Luckily, Dr. Fraser has let us post the Foreword to this book on our website.
Which improvements should be made first? Unfortunately, we seem to be arguing that some errors are more important (i.e. worse) than others. But rather than make a Chicken-or-Egg choice, David Plaut, Dr. Westgard, and Sten Westgard urge an analysis of these types of errors. The answer to the question of which improvements come first need not be "pre" or "post" or "analytical" - it should be "all three at once."
Dr. Carmen Ricos and her colleagues have provided us with an update to their 2000 Biological Variation Database. New analytes have been added, figures have been updated and in some cases, corrected. This article summarizes all the changes made to the desirable specifications for total error, bias, and imprecision (derived from biological variation) for hundreds of analytes.