TOTAL ERROR VALUE OF

CHOLESTEROL EXAMINATION
USING HALF VOLUME OF
CONTROL AND REAGENT
MATERIALS
Author :
D Setiawan, D.K Yulianti, A Farihatun,
R.N Mutmainah, K Yuhsan and N Nurfadilah
Department of Medical Laboratory Technology, STIKes Muhammadiyah Ciamis, Jl. KH
Ahmad Dahlan No. 20 Ciamis, West Java, Indonesia
Department of Pathology and Clinical Laboratories RSUD Soekardjo Tasikmalaya, West Java,
Indonesia
 Introduction
• Laboratory tests are crucial to support the diagnosis of a
disease.
• Cholesterol examination one of the many examinations
carried out in clinical laboratories.
• The importance of guaranteeing the results of
examinations, each laboratory must carry out quality
assurance
• Some laboratories do not comply with the kit insert
procedure for the sake of efficiency. The examination is
carried out with the use of half volume of the reagent and
sample.
Introduction
• Evaluation of clinical chemistry is bias (d%),
imprecision (CV), and total error.
• Accuracy values indicate the closeness of the results
to the actual value determined by the standard
method
• The precision value shows how close an examination
result is if it repeated with the same sample.
• Total Error is a combination of errors in systemic
(d%) and random error (CV%)
• The purpose of this study was to determine the effect
of using half the volume of the sample and reagent
on cholesterol checks on the total error value
Methods
• This study uses a descriptive method that is to find out
the description of the results of cholesterol checks by
using half the volume of control materials and
reagents to the total error value.
• Examination of cholesterol using methods CHOD-
PAP, with twenty- run QC material.
• Data collection techniques using primary data
obtained from cholesterol examination data conducted
by researchers at the Health Center UPTD Kawali.
Methods
• The instrument used in the study is the
Photometer5010, Micropipette, Cuvette, Timer, and
Volume Pipette.
• The material used in the study is: Material Control
(control Humatrol N with Lot. Number 0005), and
Cholesterol Reagents are ready to use (Rajawali
Nusindo).
Methods
• The sample volume and reagent used were half the
volume and the full volume with every twenty
repetitions.
• Half-volume procedure: pipette into tube sample
5µL material quality control and 500µL Reagen.
• Full volume procedure: pipette into tube sample
10µL material quality control and 1000µL Reagen.
• Mix, incubation 10 minutes at 20-25˚C, measure the
absorbance with 546 nm wavelength.
Result and Discussion
18
16
14
12
10
8
6
4
2
0
CV% d% TE%
Full volume procedure Half volume procedure
Column1
Result and Discussion
• CV% value obtained for cholesterol checks using half
the volume is 4.9%
• CV% for cholesterol checks using the full volume
1.2%,
• Examinations using a half volume have a higher
CV% of CV% full volume inspection but still within
the maximum standard CV limit of 6%
• Random analytical errors will often be caused by
unstable instruments, temperature variations, reagent
and calibration variations, inspection procedure
techniques, and operative variations.
Result and Discussion
• d% 1.5% for the results of cholesterol checks using
half the volume and d% 1.4% for the results of
cholesterol checks using the full volume, which is
close to the same
• Systematic errors generally caused by the specificity
of the reagent/method of inspection low (reagent
quality), Sample blanks and reagent blanks are
incorrect (non-linear calibration curve), reagent
quality poor calibration, inaccurate tools (pipettes),
wavelengths used, and how to dissolve reagents.
Result and Discussion
• TE% 11.9% for cholesterol testing using half the
volume and TE% value 3.81% for cholesterol
testing using full volume.
• TE% with the use of half the volume is higher than
TE% full volume.
• However, it is still below TEa which is 30%.
• Research conducted at this time, using a calibrated
photometer and micropipette equipment and
inspection procedures used by standards. TE%
results that raised on an examination that uses half
the volume caused by the use of half the volume
itself.
Conclusion

Total error value on the examination of cholesterol by

the use of half the volume is higher than the total
error value on the results of the examination with the
volume full. However, the results are still in the value
of total error allowable
 Recommendation
do a cholesterol check using full volume
to avoid mistakes. although using half the
volume is still within the total error allowed
Outcomes of the Study
from research results. finally I know that a full volume cholesterol
examination is recommended / better than half volume, even though
half volume is still within the TeA
Reference
• Bandera, S S Biswas M, and V Jain P Gokhale. 2015. “Evaluation of Imprecision , Bias and Total
Error of Clinical Chemistry Analysers.” Ind J Clin Biochem 30(1): 104–8.
• Farrer, Sterling. 2018. “Beyond Statins : Emerging Evidence for HDL-Increasing Therapies and Diet
in Treating Cardiovascular Disease.” Advances in Preventive Medicine 2018: 1–9.
• Hudayah, N., Subehan., A. Lidjadja dan M.N Djide. 2013. “Pengaruh Pemakaian Setengah Volume
Pada Pemriksaan Urea Terhadap Nilai Simpangan Baku Dan Koefisien Variasi Dengan Serum
Kontrol.” Majalah Farmasi dan Farmakologi.
• Kurniawan, Santoso. 2015. “Pengaruh Pemakaian Setengah Volume Sampel Dan Reagen Pada
Pemeriksan Glukosa Darah Metode GOD PAP Terhadap Nilai Simpangan Baku Dan Koefisien
Variasi.” Jurnal Wiyata Vol.2: 114–19.
• P. Oosterhuis, Wytze, and Elvar Theodorsson. 2015. “Total Error vs. Measurement Uncertainty :
Revolution or Evolution.” Vol.10: 2–4.
• RI, Keputusan Mentri Kesehatan. 2010. Pedoman Pemeriksaan Kimia Klinik. Jakarta: Menteri
Kesehatan Republik Indonesia.
• RI, Permenkes. 2013. Cara Penyelenggaraan Laboratorium Klinik Yang Baik. Jakarta: Menteri
Kesehatan Republik Indonesia.
• Siregar, Wulan, Setiawan, dan Nuryati. 2018. Bahan Ajar Teknologi Laboratorium Medik (TLM)
Kendali Mutu. Jakarta: Kementrian Kesehatan Republik Indonesia.
Thanks!
Any questions?