Analytical Performance Specifications Derived from External Quality Assessment Data: Comparison with Biological Variation-Based Models for Intermediate Precision Assessment

Background: Analytical performance specifications (APSs) are essential for quality management in medical laboratories. Considering the discrepancies between laboratory performance and existing guidelines, lack of consideration of concentration-dependent variability, and absence of recommendations for certain parameters, we aimed to define APSs for internal use in biochemistry, hemostasis, and hematology based on external quality assessment (EQA) peer group data and evaluate their suitability for intermediate precision assessment versus biological variation (BV)-based APSs. Methods: across laboratories and (ii) observed analytical imprecision expressed as a percentage of the allowable imprecision budget. Results: APSs were established for 110 biochemical analytes, 23 hemostasis parameters, and 28 hematology parameters across different concentration ranges. EQA-derived APSs agreed with observed intermediate precision for 102 biochemical, 14 hemostasis, and 24 hematology parameters. BV-based APSs showed agreement for only 49 biochemical, two hemostasis, and 11 hematology parameters, while overly restrictive goals or lack of agreement were observed for several analytes. Conclusions: APSs derived from pooled EQA peer group data provide realistic and technically achievable intermediate precision targets consistent with current AP and thus can complement BV-based specifications.