Bland-Altman图在男科实验室新进人员考核校验中的应用

Application of Bland-Altman method in the examination and verification of new staff in andrology laboratory

目的探索Bland-Altman图在男科实验室新进人员考核校验中的应用。方法根据《世界卫生组织人类精液检查与处理实验室手册》第5版推荐标准化精液分析方法对新进人员进行培训,并与熟练人员进行检验结果比较。采用MedCalc-version 15.8制作精子浓度、前向运动精子百分率(PR)、精子存活率、精子形态的Bland-Altman图,采用GraphPad双因素方差分析进行统计学处理。结果男科实验室新进人员经过标准化培训后先进行精确度的评估分析,新进人员检测精液样本的精子浓度、PR、精子存活率、精子形态的变异系数均小于10%。经过Bland-Altman图分析,与熟练人员比较,新进人员精子浓度检测有5%的点在95%的一致性界限以外,在一致性界限范围内,差值的绝对值最大为8×106/mL;新进人员PR分析中2.9%的点在95%的一致性界限以外,在一致性界限范围内,差值的绝对值最大为8%;新进人员精子存活率检测有2.5%的点在95%的一致性界限以外,在一致性界限范围内,差值的绝对值最大为9%;新进人员精子形态分析中2.6%的点在95%的一致性界限以外,在一致性界限范围内,差值的绝对值最大为2%。用GraphPad做双因素方差分析,两名人员检测得到的精子浓度、PR、精子存活率、精子形态具有较好一致性,差异无统计学意义(P>0.05)。结论经标准化培训,新进人员对精液浓度、PR、精子存活率、精子形态分析结果精确度好。为临床男科实验室更好地开展室内质量控制,保持实验人员检测水平的一致性提供参考。

Objective To explore the application of Bland-Altman method in the examination and verification of new staff in andrology laboratory.Methods New staff are trained in standardized semen analysis methods recommended in the fifth edition of the WHO Human Semen Inspection and Processing Laboratory Manual,and test results are compared with those of skilled personnel.MedCalc-version 15.8 was used to make Bland-Altman method of sperm concentration,percentage of PR,sperm survival rate and sperm morphology,and GraphPad was used for statistical analysis by two-factor variance analysis.Results After standardized training,the new staff were evaluated and analyzed for accuracy.The sperm concentration,PR,sperm survival rate and variation coefficient of sperm morphology of the new men were all less than 10%.By analyzing the Bland-Altman chart,5%of the new staff′s sperm concentration was beyond the 95%consistency limit.Within the consistency limit,the absolute value of the difference was 8×106/mL.2.9%of the points in the PR analysis were outside the 95%consensus limit,and within the consensus limit,the absolute value of the difference was 8%,and 2.5%of the points were outside the 95%consensus limit,within the consistency limit,the absolute value of the difference was 9%,the point of 2.6%was outside the 95%consistency limit,and within the consistency limit,the absolute value of the difference was 2%.Using GraphPad as a two-factor analysis of variance,the sperm concentration,PR,sperm survival rate,sperm morphology of the two men were well consistent,no significant difference(P>0.05).Conclusions After standardized training,the accuracy of semen concentration,PR,sperm survival rate and sperm morphology analysis of new staff is good.It can provide reference for better indoor quality control in clinical andrology laboratory and keep the consistency of testing level of laboratory staff.