Analytical performance evaluation of sensitive and old generation reagent in routine practical use: estradiol experience

YAMAN H., Yavuz H. B., KARAHAN S. C., ÖREM A., KATKAT M., Garip S. A.

SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, vol.82, no.2, pp.150-155, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 82 Issue: 2
  • Publication Date: 2022
  • Doi Number: 10.1080/00365513.2022.2038259
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.150-155
  • Keywords: Estradiol, total error, six sigma, measurement uncertainty, quality assurance, sensitivity, SIGMA METRICS, UNCERTAINTY, DENSITY, ERROR
  • Karadeniz Technical University Affiliated: Yes


Evaluation of the analytical performance of tests in medical laboratories is important. Total Error (TE) and sigma analysis have been used as a quantitative indicator of quality for many years. The aim of this study is to evaluate the analytical performance of Beckman Coulter Access Estradiol (E2) and Sensitive E2 reagents. Analytical performance of two reagents were evaluated with TE, six sigma and measurement uncertainty values. Two Beckman Coulter Unicel DxI-800 autoanalyzers (A1 and A2) included in the study. Quality control data between December 2017 and December 2019 were used. CLIA-2019 values were used for total allowable error (TEa) limits. Uncertainty values were calculated with ISO/TS 20914. The median TE of the old generation and sensitive E2 reagent were 27.46% (between 13.49 and 48.88) and 11.16% (between 7.08 and 24.81), respectively (p < .005) The process sigma results were below 3 sigma in all months with the old reagent, whereas with the new reagents it was seen to be above 3 sigma in 11 of 12 months for both autoanalyzers. Uncertainty of old reagent is higher than new reagent. Imprecisions decrease as concentration increases with both reagents. The uncertainty values of low concentration levels are greater than high concentration levels. In conclusion, in both auto analyzers, Sensitive E2 reagent was found to have better performance than old reagent in terms of TE, process sigma and measurement uncertainty. We believe that the sensitive E2 reagent still needs further improvement for patients who have low E2 levels.