Accuracy and reproducibility of automated estradiol-17β and progesterone assays using native serum samples:: results obtained in the Belgian external assessment scheme

BACKGROUND: In 2005, a special survey in the Belgian External Quality Assessment focused on the performance of six automated immunoassay analysers most frequently used in Belgium for estradiol-17 beta (E-2 and progesterone. Results obtained were compared with values determined by reference method, isotope dilution-gas chromatograph/mass spectrometry (ID-GC/MS). METHODS: Five fresh frozen serum samples, without additives, from single donors and three pools from pregnant women were distributed to all registered Belgian laboratories. Total variation, bias, linear relationship within the reported range and linear regression were investigated. RESULTS: Inter-laboratory coefficients of variation ranged from 4 to 49% for E2 and from 6 to 45% for progesterone. Bias ranged from -26 to 239% for E2 and from -23 to 81% for progesterone. Several systems showed an upward bias for one particular sample of at least 25%. Weighted linear regression showed overall bias ranging from -8% to 32% for E2 and from 7% to 41% for progesterone. CONCLUSIONS: Few automated methods succeed in having an excellent reproducibility for E2 and progesterone. Given the high bias values it is suggested that, for performance testing, results be compared whenever possible with a reference method. The linear relationship as assessed by comparing results with those obtained by ID-GC/MS using samples from different donors was not assured for most methods.