Quality control in urinary stone analysis: results of 44 ring trials (1980-2001).
Urinary stone analysis is the most important diagnostic step after stone removal from the body. The methods employed for these analyses are based on diverse analytical principles. Chemical methods are used for detecting individual ions. Infrared spectroscopy is used for examining molecular structures, and X-ray diffraction for determination of the crystalline structure of a substance. Since 1980, a twice-yearly ring trials quality control survey has been on offer to examine the quality of urinary stone analyses. A summary of the results of 44 ring trials (1980-2001) has been compiled for individual pure substances and binary (two-component) mixtures. On average, 100 laboratories have participated in these ring trials. Initially, over 80% of the participants carried out their analyses using chemical methods. In 2001, this figure decreased to a mere 13%. In contrast, a progressive increase in the use of infrared spectroscopy was observed, up to 79% of all participants employed this method. X-Ray diffraction was only employed in a small number of specialised laboratories (5-9%). The chemical methods produced a very high proportion of errors (6.5-94%) with both the pure substances and binary mixtures, whereas high error rates for infrared spectroscopy and X-ray diffraction were confined to individual substances only. Due to the poor results in the ring trials, the majority of laboratories stopped using chemical analysis, which is now considered to be obsolete. Regarding mixtures, error rates of over 10% also occurred with infrared spectroscopy and X-ray diffraction. Ring trials are indispensable for the quality management of urinary stone analysis.
Hesse
Albrecht
A
Urologische Klinik, Universitätsklinikum Bonn, Bonn, Germany. hesse@uni-bonn.de
Kruse
Rolf
R
Geilenkeuser
Wolf-Jochen
WJ
Schmidt
Matthias
M
D003951:Diagnostic Errors / Q000517:prevention & control; D006801:Humans; D011786:Quality Control; D013055:Spectrophotometry, Infrared / Q000706:statistics & numerical data; D014545:Urinary Calculi / Q000737:chemistry*; D014961:X-Ray Diffraction / Q000706:statistics & numerical data