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Clinical Chemistry 52: 2072-2078, 2006. First published September 21, 2006; 10.1373/clinchem.2006.072405
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(Clinical Chemistry. 2006;52:2072-2078.)
© 2006 American Association for Clinical Chemistry, Inc.

Laboratory Management

Improvement of Technical and Analytical Performance in DNA Sequencing by External Quality Assessment-Based Molecular Training

Alexandra Dorn-Beineke1,3, Parviz Ahmad-Nejad1,3, Ulrike Pfeiffer1, Simon Ramsden2, Mario Pazzagli3 and Michael Neumaier1,a

1 Institute for Clinical Chemistry, University Hospital Mannheim of the University of Heidelberg, Germany.
2 National Genetics Reference Laboratory (Manchester), St Mary’s Hospital, Manchester, United Kingdom.
3 Clinical Biochemistry Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.

aAuthor correspondence to this author at: Institute for Clinical Chemistry, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68167 Mannheim, Germany. Fax 49-621-383-3819; e-mail michael.neumaier{at}ikc.ma.uni-heidelberg.de.

Background: From 2003 to 2005, the European Union supported the EQUAL-initiative to develop methodological external quality assessment (EQA) schemes for genotyping (EQUALqual), quantitative PCR (EQUALquant), and sequencing (EQUALseq). As a relevant part of the EQUALseq program, a training course was held subsequent to the first EQA Program (EQAP1). The success of this course was reassessed in a 2nd EQUALseq round (EQAP2).

Methods: In September 2005, a 3-day training course took place. We invited 8 laboratories with below-average performance in EQAP1 to improve their methodological and analytical/proficiency skills by lectures and practical work. To compare the results of the pretraining and posttraining EQUALseq rounds, we distributed 2 samples used in the first EQUAL round, but this time we provided different oligonucleotide sets. We evaluated the results by means of a previously described scoring system.

Results: In EQAP2, 6 laboratories returned complete data sets, corresponding to an overall 14% of the 43 laboratories that had finished EQAP1. The scoring results for samples A (P = 0.0025) and B (P = 0.0125) demonstrated a significant improvement in EQAP2. Overall, a substantial improvement of technical and interpretative skills was demonstrated (P = 0.0051). In general, the workshop experience was highly rated by the participants.

Conclusions: Methodologic EQAPs in DNA sequencing are appropriate tools to uncover strengths and weaknesses in both technique and proficiency, emphasizing the need for mandatory EQAPs. Training courses, together with 2nd-round reiterations, should be implemented into methodological EQAPs in molecular diagnostics to improve technical performance and proficiency in genetic testing.






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Copyright © 2006 by the American Association for Clinical Chemistry.