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Each of the 12 true glucose concentrations per hour was measured by a simulated glucose assay with a defined imprecision and bias.
Thus, 100 patients were modeled for 100 h with each regimen with both the hourly and every-5-min measurement schemas under 45 combinations of simulated bias and imprecision.
This suggests that imprecision is the predominant variable in large dosing errors.
One-category insulin dosing discrepancies were common for all error conditions, similar to what was found using the bias and imprecision model.
A policy to preclude the use of assays that did not have imprecision less than 10% at the 99th percentile value might force some hospitals to change assays, and such a change has associated logistic and financial costs.
A sensitive assay with slightly more imprecision will correctly identify more patients at risk than an insensitive one with excellent precision.
The lack of interchangeability between commercial control materials and serum pools regarding day-to-day imprecision may have adverse consequences in monitoring patient results.
However, if this noninterchangeability were found among control materials from different manufacturers or, worse still, among different lots of the same control material, monitoring day-to-day imprecision during long periods would be very difficult.
Notwithstanding this, we think there is evidence enough to demonstrate that the use of the current state-of-the-art model should be the second preferred model, replacing the use of within-subject biological variation for setting requirements for imprecision for clinical laboratories.
M] be the measurement procedure imprecision (metrological coefficient of variation) and [CV.
in evaluation of estimated biological variation compared with analytical imprecision [8], and in external quality assessment of plasma proteins for the possibilities of sharing common reference intervals [9].
The basis for comparing an analytical field method with an analytical Reference Method measuring the same quantity (analyte) is the hypothesis of identity within inherent imprecision or within preset analytical quality specifications.