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Clinical Chemistry and Laboratory Medicine (CCLM)

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Volume 44, Issue 10 (Oct 2006)


Westgard multirule for calculated laboratory tests

Abdurrahman Coskun
  • Duzce University, School of Medicine, Department of Clinical Biochemistry, Duzce, Turkey
Published Online: 2011-09-21 | DOI: https://doi.org/10.1515/CCLM.2006.233


Background: In clinical laboratories, many test results such as low-density lipoprotein (LDL)-cholesterol can be calculated using the results of specifically measured tests. However, quality control programs deal only with measured tests and there is no adequate quality assessment procedure for calculated tests. I aimed to apply the Westgard multirule to calculated tests as a part of routine quality procedures.

Methods: I prepared a Levey-Jennings chart for calculated tests and all their measured components (Equation chart) and then applied the Westgard multirule to these tests.

Results: Applying the Westgard multirule to calculated LDL-cholesterol (and other calculated tests) was simple, and increased the reliability of the results of the calculated tests.

Conclusions: Checking the reliability of only measured tests by quality control procedures before reporting patient results may be inadequate. Applying the Westgard multirule to calculated tests as part of total quality management will increase the reliability of test results.

Clin Chem Lab Med 2006;44:1183–7.

Keywords: laboratory management; quality control; reliability; Westgard multirule


  • 1.

    Coskun A. The reliability of calculated laboratory tests. Clin Chem Lab Med 2005; 43:880–2. [Crossref]

  • 2.

    Coskun A. Modified Levey-Jennings charts for calculated laboratory tests. Clin Chem Lab Med 2006; 44:387–90.

  • 3.

    Coskun A. Six sigma and calculated laboratory tests. Clin Chem 2006; 52:770–1. [Crossref]

  • 4.

    Rifai N, Warnick GR. Lipids, lipoproteins, apolipoproteins and other cardiovascular risk factors. In: Burtis CA, Ashwood ER, Bruns DE, editors. Tietz textbook of clinical chemistry and molecular diagnostics. St. Louis, MO: Elsevier Saunders Inc., 2006:903–81.

  • 5.

    Westgard JO, Barry PL, Hunt MR, Groth T. A multirule Shewhart chart for quality control in clinical chemistry. Clin Chem 1981; 27:493–501.

About the article

Corresponding author: Abdurrahman Coskun, MD, Duzce University, School of Medicine, Department of Clinical Biochemistry, Konuralp-Duzce, Turkey Phone: +90-542-2380639, Fax: +90-380-5414105

Received: 2006-05-16

Accepted: 2006-07-10

Published Online: 2011-09-21

Published in Print: 2006-10-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2006.233. Export Citation

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