title: Determination of optimal replicate number for validation of imprecision using fluorescence cell based assays: Proposed practical method.
abstract: Background: Assay validation includes determination of inherent imprecision across the reportable range. However specific practical guidelines for determinations of precision for cell based fluorescence assays performed on flow cytometers are currently lacking. Methods: Replicates of 10 or 20 measurements were obtained for flow cytometric assays developed for clinical IVD use, including neutrophil CD64 expression for infection/sepsis detection, fetal red cell enumeration for fetomaternal hemorrhage detection, human equilibrative nucleoside transporter 1 (hENT1) quantitation in leukocytes for possible correlation with drug responsiveness, and CD34+ hematopoietic stem cell (HSC) enumeration of apheresis products, using up to three different instrument platforms for each assay. For each assay, the mean, 95% confidence intervals of the mean (95%CI), standard deviation and coefficient of variation (CV) of sequential replicates were determined. Results: For all assays and most instrument platforms <5 replicates were found adequate to validate assay imprecision levels below the 5-10% CV for repeatability claimed by the manufacturers of these assays. Results plotted as a novel parameter derived from the 95%CI and the cumulative mean for replicates, termed variance factor (VF), provide a data driven means for determining optimal replicate numbers. Conclusions: The novel VF can provide information to guide the practical selection of optimal replicate numbers for validation of imprecision in flow cytometric assays. The optimal number of replicates was assay and instrument platform dependent. Our findings indicate 3-4 replicates are sufficient for most flow cytometric assays and instrument combinations, rather than the higher numbers suggested by CLSI guidelines for soluble analytes. © 2013 Clinical Cytometry Society.
authors.affiliation: Trillium Diagnostics, LLC, 4 Union Street, Bangor, Maine, 04401, USA.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Davis
authors.forename: Christine E
authors.initials: CE
authors.lastname: McLaren
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Carcio
authors.forename: Linda
authors.initials: L
authors.lastname: Wong
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Hedley
authors.forename: Mike
authors.initials: M
authors.lastname: Keeney
authors.forename: Adam
authors.initials: A
authors.lastname: Curtis
authors.forename: Naomi B
authors.initials: NB
authors.lastname: Culp
keywords: Assay Validation; Flow Cytometry; IVD clearance; Quality Assessment; Sepsis Test; fetomaternal hemorrhage test; hENT1 assay; laboratory developed test; regulatory science; stem cell assay