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Unseen risks: how MU affects much more than just assays

In this final article in his latest series, Stephen MacDonald concludes by focusing on the importance of uncertainty measurement outside the narrow boundary of analytical process, into the wider realm of equipment calibration, monitoring and performance.

Throughout this latest series, our changing understanding of measurement uncertainty (MU) and its applications have been addressed. When the first series came out in 2017, MU was very much in its infancy when it came to being used in medical laboratories. Since then, we have learnt much from new guidelines, peer-reviewed publications and from a few of years of implementing it in all of our laboratories. 

The aim of this series was to update what we now know. Central to this is our improved understanding of metrological traceability and analytical performance specifications. The landscape of laboratories has also changed in this time with an emphasis on pathology networks, and, along with many other challenges, MU across multiple platforms and laboratories presents a modern challenge we are still trying to approach. Although our understanding has come so far, there is no doubt there remains some aspects we haven’t completely conquered. A satisfactory method for handling of bias, its correction and the impact on uncertainty still remains elusive. This remains a topic of sometimes heated discussion between those that follow the MU paradigm and those that argue the case for Total Error. 

Semi-quantitative and qualitative assays are also still not completely covered, even by more recent guidelines. These types of test are becoming more and more common so the need to address performance specifications and MU assessment in them is still going to be an area of interesting research moving forward. 

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