Clinical Chemistry 47: 1139-a-1140-a, 2001;
(Clinical Chemistry. 2001;47:1139-1140.)
© 2001 American Association for Clinical Chemistry, Inc.
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Book, Software, and Web Site Reviews |
Basic Planning for Quality: Training in Analytical Quality Management for Healthcare Laboratories. James O. Westgard. Madison, WI: Westgard QC, Inc., 2000, 272 pp., $60. ISBN 1-886958-13-0.
George S. Cembrowski
Department of, Laboratory Medicine and Pathology, University of Alberta Hospital, Capital Health Authority, 4B1.24 Walter C. Mackenzie Centre, 8440 112 St., Edmonton, Alberta T6G 2B7, Canada, Fax 780-407-8599, E-mail cembr001{at}cha.ab.ca
This volume is James Westgard’s third desktop-published book
and follows Basic Method Validation: Training in Analytical
Quality Management for Healthcare Laboratories and Basic QC
Practices: Training in Statistical Quality Control for Healthcare
Laboratories. All of the chapters of Basic Planning are
on the World Wide Web (www.westgard.com) and handily
accompany Westgard’s QC Validator Program (list price of $495). Unlike
the web version, the desktop-published version has an abundance of
Hagar the Horrible cartoons (King Features Syndicate). Both contain a
sprinkling of vintage medical laboratory cartoons by John Meyer. The
title of the book is misleading; it focuses on the optimization of
quality control using a commercially available computer program rather
than on the broad topic of quality.
The book contains 18 chapters and 4 appendices (my copy had
an extra introduction because of a printing error). The premise
underlying this book is that quality-control practices should be
customized for the individual laboratory and individual analytes. The
laboratorian starts with analytical performance and total error
specifications for an individual analyte [usually from CLIA’s
proficiency testing limits or physiologically based intra- and
interindividual variation (the so-called European Biologic
Goals)]. Both sets of specifications are contained in the
appendices. The total error specifications and analytical
performance are transformed by Westgard’s QC Validator
Program to obtain "OPSpecs Charts", which are then interpreted to
select the optimal quality-control procedure. The theory and
application of OPSpecs Charts have been well described by Westgard in
print (Clinical Chemistry, MLO, and even
Computer Methods and Programs in Biomedicine) and on his web
site. The preponderance of the book serves to explain the
OPSpecs Chart to the initiate (the first 15 chapters contain 
40 of
these charts and 150 references to the charts). It also
provides a rationale for customized quality-control rules in general
chemistry, blood gas analysis, immunochemistry, hematology, and
coagulation.
The question that I have always had about OPSpecs is whether all
laboratorians should be defining their own sets of customized
quality-control procedures. I suspect that all too often there is
little follow-through after the production of numerous OPSpecs Charts.
Because most laboratorians use clones of analytical instruments that
offer average performance (for that clone), it would be extremely
valuable if Westgard’s website (or another website) contained
summaries of quality-control procedures that users have found optimal
for specific instrument families (e.g., high-volume Hitachi or Vitros
chemistry analyzers). Such information would be of tremendous interest
to laboratorians who are wondering about implementing analyte-specific
quality control. Such specialized information would dramatically
shorten their quality improvement journey. Who should buy the book?
Individuals who have the program should not require the book. The book
is the apéritif or entrée for a relatively expensive
computer program (at least in Canadian currency). For this reason, the
book should be provided inexpensively; its availability atwww.westgard.com
is optimal.
