Uncategorized - Westgard QC - Blog

Tools, Technologies and Training for Healthcare Laboratories

Cut Your QC - The caveats

More than 600 of your laboratory peers are already registered for Cut Your QC. https://us02web.zoom.us/webinar/register/WN_F5IRlqySRR6eRcrm9Zz9mQ Now there are some qualifiers, of course. Not every lab nor every instrument is going to be able to reduce QC. A badly engineered instrument. Or a poorly maintained and deteriorating instrument. Or a poor...

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Diagnostics Peer-Group Sigma Study: Roche beats Siemens

An Indonesian study in Diagnostics attempted to make a comparison between Siemens and Roche instrumentation using Peer Group Sigma metrics. Out of 30 assays, Roche won 29 of 30. I can't say I wholeheartedly agree with the methodology of the study: peer group data can obscure what individual laboratories experience. The details can get lost in ...

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Six Sigma for Agriculture and Textile Chemical?

Like many authors, I keep track of where I'm cited. So I was a bit surprised to see I had been referenced in a paper in the Agricultural Association of Textile Chemical and Critical Reviews Journal: https://doi.org/10.21276/AATCCReview.2026.14.03.22 Not the usual journal I expect. But even more curious, the title of the paper is "An overview of qua...

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Cut Your QC! Free webinar 9/25/26 11 am cst

After premiering this event at ADLM, we are opening it up to everyone through zoom. Please join us September 25th, at 11 am central standard time. At last, a frank look at why we need to do less QC, and how we can make those reductions safely.  If you enjoy being out of control every day, if you get a thrill every time you have to repeat a con...

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Q and A: Establishing a new mean and SD within the manufacturer's range

"I have a question about establishing a Levey-Jennings control chart. laboratories should collect a minimum of 20 measurements over at least 10 days to calculate the mean and SD for the chart. My question is: Is it required that these initial 20 data points must fall within the manufacturer's declared range (or assigned values) for the control...

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Should Labs impose Desperation Premiums?

Every so often it's useful to transpose a few practices from outside the laboratory into the laboratory, just to see how we would evaluate them. The new Tech powers are gleefully implementing a system called "surveillance pricing", which they sell as a dynamic way to sell things to customers, except it turns out that they really only want the prici...

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Indonesian hematology analyzer that can't hit anything

A paper from Surabaya, Indonesia assessed the performance of an anonymous hematology analyzer. The study used the old CLIA 1992 goals. We updated it with an assessment using CLIA 2025 goals. And then it became clear why this instrument was not named. None of this performance would meet CLIA's standards. Is performance so bad in this analyzer, ...

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Question and Answer: How to use the 7:T rule?

This question recently came in: "We have two specific questions regarding the practical application of the 7T rule: "When applying this rule, is it mandatory to use the 1:2s rule as a starting trigger, or can the laboratory choose to use 7T independently without the 1:2s initiation? (Personally, I believe 1:2s initiation is necessary….) "When a 7T ...

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4:1s, when is it violated under different types of Westgard Rules?

The Westgard Rules, in the classic 1981 multirule paper, require a 1:2s violation before other rejection rules are violated.  If you had4 values past 1s, but nothing past 2s, it wouldn't be checked. Under more "modern" Westgard Rules, with the 1:2s warning rule abolished, you don't need to wait until the 2s limit line is violated before interp...

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Repeating the control: just more info, or just rolling the dice?

A recent question popped up in one of our recent webinars: "It seems to me that repeating a QC may or may not have value, yes if it provides further troubleshooting data, and not if it is used to override a proper error flag. But to group the two together, without making that distinction seems inappropriate. Perhaps expand the survey ques...

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Q and A: Is the 10:x rule still compulsory?

A recent question came to me via social media: "Hello Sir, Good morning, How are you? I wanted to know is still 10x rule is coumpulsary?[stet.]  Even [when] we are using lab mean and lab SD. Please share the details.Thanks and Regards, [anonymous]"10:x is not compulsory by any regulation that I am aware of. Many regulations require you to...

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"Real" analytical Sigma metrics, a rarity

[Full disclosure, Westgard QC has a partnership with Beckman Coulter. However, this paper was not prepared by Westgard, but was written completely independently. We are simply calling attention to the study's unique approach and findings.] A new study from Tamil Nadu, India, has gone into unprecedented detail of the analytical performance. Typicall...

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CGM quality, compromised?

A significant new paper just became available online, tackling the difficult challenge of CGM quality: Clinical assessment and acceptance criteria for continuous glucose monitoring (CGM) system performance: A proposed guideline by the IFCC Working Group on CGM, Pleus S, Eichenlaub M, Dabla PK, Diem P, Boija EE, Fokkert M, Hinzmann R, Jendle J, Klon...

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What Six Sigma Feels like... (and 2,3,4, and 5 too)

Interesting study published recently in the October 2025 issue of Philippine Journal of Pathology: Mark Angelo Ang, Karen Cybelle Sotalbo, Quantifying Total Allowable Error Violations in Serum-Sodium Quality Control: A Computer Simulation Experiment of Two- to Six-Sigma Processes, October 2025, Philippine Journal of Pathology 10(2), DOI: 10.21141/P...

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Are labs getting ensh***fied?

The term "enshittification" is having a moment right now. It was coined in 2022 by the author/essayist Cory Doctorow, and named the 2023 and 2024 word of the year by the American Dialect Society  and the Macquarie Dictionary, but the publication of the eponymous book is bringing it to the fore. Enshittification is a on...

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198 Questions: Where do I start with Six Sigma?

We're still working through questions that came up in our Global QC Survey results webinar. Question: What's your advice to labs new to Sigma metrics? How to gradually transition? We're at an interesting time in the evolution of analytical Six Sigma metrics. Many of the major control vendors have built analytical Sigma metric calculations righ...

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199 Questions: What can poor labs do?

199 questions from the Beckman Coulter Webinar. Another common inquiry I have gotten over the last few months concerns the advanced technique of Six Sigma and its applicability in not-so-advanced laboratories. In other words, what can resource-challenged laboratories do with Six Sigma metrics? This question applies not only to hematology, but to an...

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A new game: 200 questions?

Driving Quality in Hematology: New Global Standards, Interlaboratory Data, and Real-World Sigma Metric Success | Beckman Coulter DX HGM .... https://app.livestorm.co/beckman-coulter-dx-hgm/driving-quality-in-hematology-new-global-standards-interlaboratory-data-and-real-world-sigma-metric-success?s=0b6c18b1-6f1e-4c6f-90ee-48cf88783f8d We had more th...

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#CLINICAL24 celebrates the lab

Happy to be part of the #CLINICAL24 celebration of laboratory professionals and laboratory medicine again this year. My own small contribution to this global conversation can be found here: https://www.selectscience.net/video/maintaining-qc-accuracy-in-clinical-labs-through-responsible-ai-use #clinical24 #westgardrules #westgardsurveys

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European QC habits: more QC, more problems

Where do labs run more QC more often than anywhere else?https://westgard.com/qc-applications/basic-qc-practices/2025-qc-survey-europe.html See the latest findings from the Westgard Global QC Survey.Sometimes more QC just means more (self-inflicted) problems. #westgardrules And if you don't want to glance through hundreds of graphs, you can get the ...

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