Received on April 27, 2006
Accepted on August 16, 2006

Laboratory Management

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

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

^* To whom correspondence should be addressed. 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.