Establishing reference laboratories in laboratory medicine

The concept of measurement traceability provides probably the most important strategy to achieve standardization in laboratory medicine aimed at comparable measurement results regardless of the method, the measurement procedure (test kit) and of the laboratory where analyses are carried out. Establishing networks of reference laboratories is - in addition to reference measurement procedures and reference materials - one of the biggest challenges in implementing the concept of measurement traceability. With respect to these requirements, the Joint Committee on Traceability in Laboratory Medicine (JCTLM), established by the BIPM, the IFCC and the ILAC, has launched two projects in its working groups. WG-1 has to date published tables of reference materials and reference procedures on the BIPM web-sites, whereas WG-2 is identifying reference measurement laboratories. There is general agreement now that reference laboratories should be identified - according to the metrological level of the procedures applied where the principle of measurement is the most important criterion, - on the basis of accreditation or at least compliance with ISO 15195 or ISO 17025 as calibration laboratory, and - on the basis of their ability to demonstrate performance in regular inter - laboratory comparisons (ring trials). To date, a data base on candidate reference laboratories has been collected containing information on the laboratory identity, the metrological level of the procedures and on the status of accreditation and the participation in networks or ring trials. The data base currently contains the addresses of about 60 laboratories. On average, each of the laboratories reported measurement capabilities for six different measurands resulting in about 360 entries. The IFCC has recently launched a ring trial program for reference laboratories for some thirty different measurands. Ring trial results not only demonstrate the competence of individual laboratories, but also reveal the equivalence or bias of different reference procedures. .