Westgard rules

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The Westgard rules are a set of statistical patterns, each being unlikely to occur by random variability, thereby raising a suspicion of faulty accuracy or precision of the measurement system. They are used for laboratory quality control, in "runs" consisting of measurements of multiple samples. They are a set of modified Western Electric rules, developed by James Westgard and provided in his books and seminars on quality control. [1] They are plotted on Levey–Jennings charts, wherein the X-axis shows each individual sample, and the Y-axis shows how much each one differs from the mean in terms of standard deviation (SD). The rules are: [2]

Contents

RuleCriteriaSuspectedExample
12sOne measurement exceeds 2 standard deviations either above or below the mean of the reference range. Inaccuracy and/or imprecision Westgard rule 12s.jpg
13sOne measurement exceeds 3 standard deviations either above or below the mean of the reference range.Inaccuracy and/or imprecision Westgard rule 13s.jpg
22s2 consecutive measurements exceed 2 standard deviations of the reference range, and on the same side of the mean.Inaccuracy and/or imprecision Westgard rule 22s.jpg
R4sTwo measurements in the same run have a 4 standard deviation difference (such as one exceeding 2 standard deviations above the mean, and another exceeding 2 standard deviations below the mean).Imprecision. Westgard rule R4s.jpg
41s4 consecutive measurements exceed 1 standard deviation on the same side of the mean.Inaccuracy. Westgard rule 41s.jpg
10x10 consecutive measurements are on the same side of the mean.Inaccuracy. Westgard rule 10x.jpg

The recommended consequences when any of the above patterns occur is to reject the run, except for the rule of 12s (top in table), which serves as a warning and a recommendation of careful inspection of the data. [2]

See also

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References

  1. Ofer Harel; Enrique F. Schisterman; Albert Vexler & Marcus D. Ruopp (July 2008). "Monitoring Quality Control: Can We Get Better Data?". Epidemiology. 19 (4): 621. doi:10.1097/ede.0b013e318176bfb2. PMC   2625303 . PMID   18496467.
  2. 1 2 Heidi Hanes. "Westgard Rules - Guidelines". SMILE, Johns Hopkins University. Review date: 1 April 2020