title: Revised system to evaluate measurement of blood chemistry data from the Japanese National Health and Nutrition Survey and Prefectural Health and Nutrition Surveys.
abstract: BACKGROUND
  We developed a monitoring system that uses total errors (TEs) to evaluate measurement of blood chemistry data from the National Health and Nutrition Survey (NHNS) and Prefectural Health and Nutrition Surveys (PHNS).
  
  
  METHODS
  Blood chemistry data from the NHNS and PHNS were analyzed by SRL, Inc., a commercial laboratory in Tokyo, Japan. Using accuracy and precision from external and internal quality controls, TEs were calculated for 14 blood chemistry items during the period 1999-2010. The acceptable range was defined as less than the upper 80% confidence limit for the median, the unacceptable range as more than twice the cut-off value of the acceptable range, and the borderline range as the interval between the acceptable and unacceptable ranges.
  
  
  RESULTS
  The TE upper limit for the acceptable and borderline ranges was 5.7% for total cholesterol (mg/dL), 9.9% for high-density lipoprotein cholesterol (mg/dL), 10.0% for low-density lipoprotein cholesterol (mg/dL), 10.4% for triglycerides (mg/dL), 6.6% for total protein (g/dL), 7.6% for albumin (g/dL), 10.8% for creatinine (mg/dL), 6.5% for glucose (mg/dL), 9.7% for γ-glutamyl transpeptidase (U/L), 7.7% for uric acid (mg/dL), 8.7% for urea nitrogen (mg/dL), 9.2% for aspartate aminotransferase (U/L), 9.5% for alanine aminotransferase (U/L), and 6.5% for hemoglobin A1c (%).
  
  
  CONCLUSIONS
  This monitoring system was established to assist health professionals in evaluating the continuity and comparability of NHNS and PHNS blood chemistry data among survey years and areas and to prevent biased or incorrect conclusions.
authors.affiliation: National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, CDC/CRMLN Lipid Reference Laboratory, Suita, Osaka, Japan. nakamura.masakazu.hp@mail.ncvc.go.jp
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kiyama
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitamura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Noda
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yoshiike
mesh_terms: D001774:Blood Chemical Analysis; D006306:Health Surveys / Q000592:standards*; D006801:Humans; D007564:Japan; D009749:Nutrition Surveys / Q000592:standards*; D011786:Quality Control; D015203:Reproducibility of Results