MultiQC is a Windows software application for quality
control in clinical chemistry. It is the work of a French
chemical pathologist eager to find a remedy to the
heterogeneity, the inappropriate design and the poor
efficiency of the commercial products created by teams of
IT specialists copying each other or obsolete
recommendations. They froze QC practices of medical
laboratories to a changeless state for several decades
while industrial QC was making great advances
QC driven by
capability indices
QC in
clinical chemistry is aimed at keeping analytical
uncertainties within medical tolerance at the
lowest cost to achieve the most profitable
zero-defect laboratory output. For each test, the
difficulty of the task is reliant on the relative
extents of tolerance and uncertainty. The
capability indice is the ratio of the former to
the latter. It decides on the way to perform QC :
- Low
capability methods : Quality control is
essential to keep them in-control.
- High capability methods : They
may perform out-of-control and produce
however acceptable results. An acceptance chart (pdf file 130 KB) should
be prefered because it saves time and cuts costs
in comparison to control charts.
- Incapable methods : They must
be improved or discarded.
Up-to-date
statistical tools
In
addition to Shewhart (Levey and Jennings) charts,
MultiQC implements more recent statistical tools
- Exponentially
weighted moving average (EWMA) to monitor the
bias
- Exponentially weighted moving variance (EWMV)
to monitor the imprecision
- Multivariate process control (Hotelling's T2)
to monitor multi-level quality control.
MultiQC
ignores the "Westgard rules" which were
formerly considered as a standard in clinical
laboratories but turned out to be inappropriate
to today's analysers: Misconceptions in medical
laboratory quality control (pdf file 510 KB).
Versatile QC
methods and parameter modes
QC methods
Parameter
modes
Non
statistical
1)
Target and allowed deviation defined by the
reagent maker
Univariate
Multivariate
Acceptance
2)
Mean and CV estimated from a reference historical
pool
3)
Mean and CV known a priori
4)
Floating mean and CV when a new analyte is
started
5) Retained CVand floating mean when a new lot of control
material is started
Plotting QC data
and EQA returns on the same chart
MultiQC plots
external quality assessment (EQA) returns
superimposed on the same charts as QC data. The
position of the lab in comparison to the peer
group is thus made permanently visible by the
involved staff for an easy and complete follow-up
of the analytical process (precision and
trueness).
A built-in
management for changes of QC material batches
When it is
necessary to switch to a new lot of QC material,
control charts can be temporarily duplicated to
keep the analytical method under control of the
older batch while a reference pool is collected
for the newer batch.
Monitoring the time
of QC
MultiQC can
monitor whether QC assays have been performed in
compliance with a timetable specific to each
analyte. When QC assays have been missed the
program opens a warning window which displays a
list of the missing tests and sends out a
customizable music.
Continuous method
validation
MultiQC
provides tools to continuously evaluate the
performance characteristics of each analytical
method that it controls. A unique feature is that
performance is always related to medically
allowed error. The resulting data and plots are
stored within QC charts as "analytical
events", easy to consult to troubleshoot
out-of-control situations or bad EQA returns.
1) Verifying
the reportable range : MultiQC includes
an original linearity software which takes the
place of the former "LinChecker"
software by the same author. Several years of
practice have demonstrated that the linearity
protocol EP6-A by the CLSI / NCCLS is not
appropriate to the practical needs of clinical
chemistry laboratories.
2) Method
comparison : An improved version of the
former "Method Validator" software by
the same author is included in MultiQC. It bases
comparison of analytical methods on medically
allowed tolerance. Classical regression tools
(ordinary linear regression, Deming regression,
weighted Deming regression, Passing-Bablok
regression) and the difference plot (modified
Bland-Altman) are implemented.
- Sample comparison report (pdf file, 70 KB)
- Read a discussion about method comparison : Method comparison (pdf file 170 KB)
- See the flash demo below.
3) Repeatability
verification : Estimating repeatability by
replicated assays of the same sample is the first
action to perform to troubleshoot an analytical
issue. MultiQC saves histogram and coefficients
of variation to facilitate the follow-up of each
analytical method.
- See the flash
demo below.
MultiQC flash demos
The following demos
(about 5 minutes each) are provided for an easier
approach of MultiQC.
Subject
On-line
flash demo
Off-line
demo exe file
A brief tour in
multiQC
Starting a new
batch of control materials
Control
parameters
Verifying the
reportable range
Comparison of
analytical methods
Verifying
repeatibility
Snapshot of the
main screen
Click the picture
to enlarge
Direct acquisition
of QC and EQA data
Results of QC
assays and EQA returns can be entered into
MultiQC by hand either analyte by analyte or
grouped into profiles. A better way is direct acquisition without keyboarding.
The user manual
of MultiQC is included in the installation
package but it can be separately consulted before
deciding to download : MultiQC5.pdf (1.7 MBytes).
Click on MultiQC 5.4.0.10 to download the
installation package (4.0 MBytes). This is the
full version of MultiQC with nothing disabled
except a 60-day time limitation. After logging in
Windows as an administrator or a poweruser,
launch the setup file to proceed to installation
and follow the instructions.
MultiQC is
released under the shareware concept. Only buy
MultiQC when you're sure it meets your needs
after a free 60-day evaluation period. At any
time during or after your 60-day period you can purchase a license and keep on using your QC
data. Updates are free for a full version cycle.
Upgrades:
Minor version upgrades are free of
charge. Version 5.X.Y.Z is a free upgrade for
registered users of Version 5. Simply download
and install the latest version (without
uninstalling the previous one) and you will be
upgraded to the latest version. The new version will take
the place of the older one and let your QC data
unchanged. If your current version 5 is older
than 5320 you will need a free new registration key.
