Monitoring QC Data
Levey-Jennings Chart
1 .2
0.8
0.4
Levey-Jennings Chart
3 SD
2 SD
1 SD
Mea
n
1 SD
2 SD
3 SD
3
Monitoring QC Data
Meet pre-established limits, usually
Rules
Use premise that 95.5% of control
values should fall within 2SD
Commonly applied when two levels
of control are used
Use in a sequential fashion
5
Westgard Rules
1 2s rule
1 3s rule
2 2s rule
R-4s rule
4 1s rule
10x rule
6
Westgard 1 2s Rule
warning rule
One of two control results falls
outside 2SD
Alerts tech to possible problems
Not cause for rejecting a run
Must then evaluate the 1 3S rule
7
12S rule
violation
-1SD
-2SD
-3SD
Day
8
Westgard 1 3s Rule
If either of the two control results
13S rule
violation
-2SD
-3SD
Day
10
Westgard 2 2s Rule
2 consecutive control values for the
11
22S rule
violation
-2SD
-3SD
Day
12
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Day
14
Westgard 4 1s Rule
Requires control data from previous
runs
Four consecutive QC results for one
level of control are outside 1SD, or
Both levels of control have
consecutive results that are outside
1SD
15
Control Rule
Violations 4-1S
3SD
2SD
1SD
Mean
-1SD
Glucose
(Level I)
-2SD
-3SD
10
11
12
13
14
15
16
runs
Ten consecutive QC results for one
level of control are on one side of the
mean, or
Both levels of control have five
consecutive results that are on the
same side of the mean
17
10x rule
violation
-2SD
-3SD
Day
18
out of control
Stop testing
Identify and correct problem
Repeat testing on patient samples
and controls
Do not report patient results until
problem is solved and controls
indicate proper performance
19
Analysis of QC Data
Over Time
Levey-Jennings control charts
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
22
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
23
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
24
1 2s Rule: Warning
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
25
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
26
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
27
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
28
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
29
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
30
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
31
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
32
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
33
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
34
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
35
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
36
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
37
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
38
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
39
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
40
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
41
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
42
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
43
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
44
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
45
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
46
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
47
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
48
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
49
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
50
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
51
Urea: mg/ dl
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
52
Urea: mg/ dl
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
Level 1
36.98
35.32
33.66
32.00
30.34
28.68
27.02
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Level 2
+3SD
+2SD
+1SD
Mean
-1SD
-2SD
-3SD
54.56
53.04
51.52
50.00
48.48
46.96
45.44
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
53
Westgard Multirule QC
54