{"presentation":{"slides":[{"elements":[{"x":4.357298474945534,"y":4.319654427645788,"width":89.32461873638344,"height":95.03239740820734,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

Monitoring of quality indicators is an essential component of quality assurance for the Cartridge-based Nucleic Acid Amplification Test (CBNAAT).<\/p>\n\n

Routine monitoring of quality (performance) indicators:\n\t
1. Critical element of quality assurance for any diagnostic test <\/li>\n\t\t
2. International Organisation of Standardisation (ISO) requirement<\/li>\n\t<\/ol>\n\t<\/li>\n\t
3. Each testing site should collect and analyze quality indicators monthly.<\/li>\n\t
4. Document and investigate any unexplained change in quality indicators, such as:\n\t
  1. Increase in error rates<\/li>\n\t\t
  2. Change in Mycobacterium tuberculosis<\/em> (MTB) positivity rate or Rifampicin (Rif) resistance rate<\/li>\n\t\t
  3. Significant change in volume of tests conducted<\/li>\n\t\t
  4. Error rates > pre-determined threshold (>5%)<\/li>\n\t\t
  5. Test turnaround time<\/li>\n\t<\/ol>\n\t<\/li>\n\t
  6. All unexpected trends should be reviewed by the laboratory manager and linked to corrective actions.<\/li>\n\t
  7. Standard set of quality indicators should be used for all CBNAAT testing sites.<\/li>\n\t
  8. System should be in place for centralized reporting of monthly quality indicators.<\/li>\n<\/ul>\n"},"subContentId":"cf5f32ba-4d77-4518-9bd8-dea0c4ba33e2","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":2.178649237472767,"y":2.159827213822894,"width":51.19825708061002,"height":92.87257019438445,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
    \n\t
    All unexpected trends should be reviewed by the laboratory manager and linked to corrective actions.<\/li>\n\t
    Standard set of quality indicators should be used for all CBNAAT testing sites.<\/li>\n\t
    System should be in place for centralized reporting of monthly quality indicators.<\/li>\n\t
    Each instrument should be monitored monthly, using the following minimum set of indicators<\/strong><\/span> to evaluate proper use:\n\t
    \n\t\t
    Number of tests performed per month<\/li>\n\t\t
    Number and proportion of MTB detected; Rif-resistance not detected<\/li>\n\t\t
    Number and proportion of MTB detected; Rif-resistance detected<\/li>\n\t\t
    Number and proportion of MTB detected, Rif-indeterminate<\/li>\n\t\t
    Number and proportion of MTB not detected<\/li>\n\t\t
    Number and proportion of errors<\/li>\n\t\t
    Number and proportion of invalid results<\/li>\n\t\t
    Number and proportion of no results<\/li>\n\t\t
    Median time to result after receipt of the specimen<\/li>\n\t<\/ol>\n\t<\/li>\n<\/ul>\n"},"subContentId":"1675e61d-80f4-47ee-b704-232c2ce6a2db","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":54.46623093681917,"y":6.506479481641468,"width":42.48366013071895,"height":77.7537796976242,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
    4.Number and proportion of MTB detected, Rif-indeterminate<\/p>\n\n
    5.Number and proportion of MTB not detected<\/p>\n\n
    6.Number and proportion of errors<\/p>\n\n
    7.Number and proportion of invalid results<\/p>\n\n
    8.Number and proportion of no results<\/p>\n\n
    9.Median time to result after receipt of the specimen<\/p>\n"},"subContentId":"d60cf6e8-0e39-4d4c-aa25-b84528ec1434","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":6.5359477124183005,"y":92.87257019438445,"width":39.97821350762527,"height":5.183585313174946,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
    Figure: Monthly Quality Indicators for CBNAAT<\/p>\n"},"subContentId":"bcd56f11-40a2-43bf-8cd8-ffc8601bf0da","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":3.266045751633987,"y":6.491576673866091,"width":26.143790849673202,"height":39.956803455723545,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f5dc061a9.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":386,"height":309},"alt":"cbnaat quality indicator 1","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"e45350ee-4ade-4a6d-9a7f-35923dd405b4","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":3.2679738562091503,"y":49.676025917926566,"width":26.22998052797689,"height":40,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f5fba7a6a.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":386,"height":298},"alt":"cbnaat quality 2","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"ed7500e8-608a-4e1b-a359-22621fc0dc0c","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":30.499128540305016,"y":6.491576673866091,"width":34.64052287581699,"height":82.07343412526998,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f61d8610e.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":486,"height":581},"alt":"cbnaat quality indicators3","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"a2f66a37-a266-469b-a559-1e4f969e5393","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":66.44880174291939,"y":45.35637149028078,"width":33.00653594771242,"height":21.598272138228943,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f64e511eb.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":486,"height":161},"alt":"CBnaat quality indicator 5","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"c10c73e9-b6d7-4880-8479-0289564906d6","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":66.44880174291939,"y":71.27429805615552,"width":32.46187363834423,"height":15.982721382289418,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f68412c21.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":486,"height":121},"alt":"cbnaat quality indcator6","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"988e902a-33e5-4c04-a4ae-b1066e65ae64","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":66.44880174291939,"y":6.479481641468682,"width":32.6797385620915,"height":31.965442764578835,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","file":{"path":"images\/file-6494f6e691b6c.jpg","mime":"image\/jpeg","copyright":{"license":"U"},"width":486,"height":241},"alt":"4","expandImage":"Expand Image","minimizeImage":"Minimize Image"},"subContentId":"970d4294-0c65-4dba-a7f8-076fef66b48f","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":2.1757625272331156,"y":36.75269978401728,"width":88.23529411764706,"height":63.2829373650108,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
    Quality Indicator Monitoring: Troubleshooting Aid<\/strong><\/span><\/p>\n\n
    Identifying the number and type of various errors can help with troubleshooting since certain errors may be associated with processing, instrumental or environmental conditions<\/p>\n\n
    The following analyses may be performed:<\/p>\n\n
    \n\t
    The number of errors occurring by user<\/li>\n\t
    The number of errors occurring by instrument module<\/li>\n\t
    The number of tests lost due to power outages or surges<\/li>\n\t
    The number, duration and causes of routine interruptions in the CBNAAT testing service<\/li>\n<\/ul>\n"},"subContentId":"1018720b-9468-4ef8-a73e-57306fa0a535","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":2.1741503267973856,"y":8.659676025917925,"width":92.5925925925926,"height":15.11879049676026,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
    Where possible, disaggregated data according to the tested population group (HIV positive, Multi-drug resistance (MDR) risk, extrapulmonary or paediatric TB) is collected.<\/p>\n\n
    <\/p>\n"},"metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"a224549f-6d40-4eff-a5dc-84420133d76a"},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}}],"keywordListEnabled":true,"globalBackgroundSelector":{},"keywordListAlwaysShow":false,"keywordListAutoHide":false,"keywordListOpacity":90},"override":{"activeSurface":false,"hideSummarySlide":false,"summarySlideSolutionButton":true,"summarySlideRetryButton":true,"enablePrintButton":true,"social":{"showFacebookShare":false,"facebookShare":{"url":"@currentpageurl","quote":"I scored @score out of @maxScore on a task at @currentpageurl."},"showTwitterShare":false,"twitterShare":{"statement":"I scored @score out of @maxScore on a task at @currentpageurl.","url":"@currentpageurl","hashtags":"h5p, course"},"showGoogleShare":false,"googleShareUrl":"@currentpageurl"}},"l10n":{"slide":"Slide","score":"Score","yourScore":"Your Score","maxScore":"Max Score","total":"Total","totalScore":"Total Score","showSolutions":"Show solutions","retry":"Retry","exportAnswers":"Export text","hideKeywords":"Hide sidebar navigation menu","showKeywords":"Show sidebar navigation menu","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","prevSlide":"Previous slide","nextSlide":"Next slide","currentSlide":"Current slide","lastSlide":"Last slide","solutionModeTitle":"Exit solution mode","solutionModeText":"Solution Mode","summaryMultipleTaskText":"Multiple tasks","scoreMessage":"You achieved:","shareFacebook":"Share on Facebook","shareTwitter":"Share on Twitter","shareGoogle":"Share on Google+","summary":"Summary","solutionsButtonTitle":"Show comments","printTitle":"Print","printIngress":"How would you like to print this presentation?","printAllSlides":"Print all slides","printCurrentSlide":"Print current slide","noTitle":"No title","accessibilitySlideNavigationExplanation":"Use left and right arrow to change slide in that direction whenever canvas is selected.","accessibilityCanvasLabel":"Presentation canvas. Use left and right arrow to move between slides.","accessibilityProgressBarLabel":"Choose slide to display","containsNotCompleted":"@slideName contains not completed interaction","containsCompleted":"@slideName contains completed interaction","slideCount":"Slide @index of @total","containsOnlyCorrect":"@slideName only has correct answers","containsIncorrectAnswers":"@slideName has incorrect answers","shareResult":"Share Result","accessibilityTotalScore":"You got @score of @maxScore points in total","accessibilityEnteredFullscreen":"Entered fullscreen","accessibilityExitedFullscreen":"Exited fullscreen","confirmDialogHeader":"Submit your answers","confirmDialogText":"This will submit your results, do you want to continue?","confirmDialogConfirmText":"Submit and see results","slideshowNavigationLabel":"Slideshow navigation"}}

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Ch 06: Monitoring CBNAAT quality and lab performance

Target Audience

External Quality Assurance for CBNAAT

Monitoring of CBNAAT Quality Indicators