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Implementation phase of NORIP

Implementation phase of NORIP. Gunnar Nordin, EQUALIS, Uppsala. Common Nordic Reference Values, Session 15, NFKK 24 – 27 April 2004. NORIP. For the first time fully documented and traceable reference limit values Information needed to Colleagues in the field of laboratory medicine

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Implementation phase of NORIP

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  1. NORIP, Malmö 27/4-2004 Implementation phase of NORIP Gunnar Nordin, EQUALIS, Uppsala Common Nordic Reference Values, Session 15, NFKK 24 – 27 April 2004

  2. NORIP, Malmö 27/4-2004 NORIP • For the first time fully documented and traceable reference limit values • Information needed to • Colleagues in the field of laboratory medicine • All requesters of tests in the health care systems • Others, e.g. organizers of multi center studies

  3. NORIP, Malmö 27/4-2004

  4. NORIP, Malmö 27/4-2004 How should X be used?

  5. NORIP, Malmö 27/4-2004 How should X be used? • Evaluation and verification of the performance of routine clinical measurement procedures • Make routine results traceable to common reference intervals for the Nordic countries (NORIP data) • Laboratories not able to reproduce the stated values of X – try to find the reason! (together with the supplier!)

  6. NORIP, Malmö 27/4-2004 Evaluation of results from X by the Excel sheet

  7. NORIP, Malmö 27/4-2004 How should X not be used? • X is not a substitute for the calibrators supplied by IVD manufacturers!

  8. NORIP, Malmö 27/4-2004 Status of IFCC enzymesApril 2004 • Norway 100% (since May 2003) • Denmark 50% • Sweden 15% • Finland (May 2004) • Iceland (Autumn 2004?)

  9. NORIP, Malmö 27/4-2004 Implementation of NORIP in Norway • Implementation of clinical chemistry will start after publication and information in “Tidsskrift for Norsk Legeforening” June 2004. • Checklist published on NKK website • Implementation of haematology to be discussed.

  10. NORIP, Malmö 27/4-2004 Implementation of NORIP in Sweden • Implementation during 2004 recommended by SFKK. • March 04 information in “Läkartidningen” • Checklist on EQUALIS Website • Users of Jaffémethods for creatinine are recommended by SFKK and EQUALIS to use creatinine free serum (see poster 78) • April 04 full implementation by the pioneer laboratories

  11. NORIP, Malmö 27/4-2004 Implementation* of NORIP in Sweden April 04 *) Exceptions for Potassium and Calcium made in two districts. Several districts plan forimplementation during summer and autumn 04

  12. NORIP, Malmö 27/4-2004

  13. NORIP, Malmö 27/4-2004

  14. NORIP, Malmö 27/4-2004 Analysens CV% = 2,6 ?

  15. NORIP, Malmö 27/4-2004 Why might data not fit? • Optimal preanalytical conditions in NORIP • NORIP used serum tubes without gel • Multiple tubes collected during venepunction • ????

  16. NORIP, Malmö 27/4-2004 Implementation of NORIP in Finland • Haematology implemented Jan 04 • Finnish Society recommends implementation in clinical chemistry May 04 • HUCS/HUS plan to implement May 04 • Other laboratories probably autumn 04

  17. NORIP, Malmö 27/4-2004 Implementation of NORIP in Iceland • Iceland: • Information will be given to clinicians and in ‘Lægeforeningens’ journal later this year

  18. NORIP, Malmö 27/4-2004 Implementation of NORIP in Denmark • DSKB has not yet recommended time for implementation of non-enzymes clinical chemistry.

  19. NORIP, Malmö 27/4-2004 Secondary effects of NORIP • General clinical chemistry: • Harmonization of Jaffé and enzymatic methods for creatinine • Test of the validity of the NPU system for the systematic nomenclature and codes for measured properties • Haematology: • Common recommendation to use dry K2-EDTA • Replacement of the old fashioned ‘% haematocrit’ with EVF (Sweden)

  20. NORIP, Malmö 27/4-2004 Two different codes for creatininium in plasma: NPU01807 P—Creatininium; subst.c.(Jaffé) = ? µmol/l NPU04998 P—Creatininium; subst.c.(enz.) = ? µmol/l NPU system for nomenclature and codes used in Denmark and Sweden NPU04998 should be used for Jaffé-creatinine after calibration with creatinine free serum!

  21. NORIP, Malmö 27/4-2004 New NPU codes because new traceability New codes for new methods NPU system for nomenclature and codes used in Denmark and Sweden

  22. NORIP, Malmö 27/4-2004 The future • Evaluation of potential limitations of NORIP reference intervals, e.g. potassium, calcium and LD. • National EQA organizers should collect experiences from implementation • The NORIP working group (NOBIDA?) should be asked by NFKK to evaluate the final implementation • Complete use of the collected data in the NORIP • E.g. reference intervals for the differential count, reticulocytes and other haematological properties • Reference intervals for children. • Working group established by NFKK • Further harmonization (???) • The unit katal for enzymes • Substance concentration for B-Haemoglobin (mmol/L)

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