{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:40:38Z","timestamp":1789486838560,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Clinical laboratories operating multiple analyzers with random sample allocation must ensure result comparability across instruments to support consistent clinical interpretation and patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the applicability of the CLSI EP31\u2010A\u2010IR guideline for periodic verification of patient result comparability across multiple hematology analyzers, and to assess the longitudinal stability of this model over a four\u2010year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Comparability of nine DxH\u2010900 hematology analyzers (Beckman Coulter) was evaluated for 17 parameters, including complete blood count variables, leukocyte differentials, monocyte distribution width (MDW), and reticulocytes. Following the EP31\u2010A\u2010IR framework, approximate target concentrations were estimated from internal quality control data at three concentration levels to guide the selection of native patient samples covering clinically relevant ranges, including samples from oncohematological and sepsis\u2010suspected patients. Acceptance criteria (AC) based on biological variation (BV) were established for each parameter and concentration level. The maximum allowable difference (MAD), as well as the number of runs and replicates, were calculated accordingly. Results were considered comparable when the maximum observed difference (MOD) was less than or equal to the MAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all 17 parameters evaluated, including reticulocytes assessed on a subset of four analyzers reflecting routine workflow, the MOD between instruments remained within predefined acceptance limits at all concentration levels. Longitudinal monitoring over a four\u2010year period (2022\u20132025) demonstrated sustained inter\u2010analyzer agreement, with no evidence of progressive analytical drift.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The EP31\u2010A\u2010IR guideline proved to be a flexible and effective framework for periodic verification of patient result comparability in high\u2010volume hematology laboratories. This study represents one of the first implementations of this guideline in the field of hematology, supporting reliable clinical interpretation across analytical platforms and fulfilling ISO 15189 accreditation requirements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70243","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:24:16Z","timestamp":1789478656000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Verification of Patient Result Comparability Among Nine Hematology Analyzers Using the\n                    <scp>CLSI EP31<\/scp>\n                    \u2010A\u2010\n                    <scp>IR<\/scp>\n                    Guideline: A Four\u2010Year Experience"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3964-6119","authenticated-orcid":false,"given":"Xavier","family":"Tejedor\u2010Gandux\u00e9","sequence":"first","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2324-4003","authenticated-orcid":false,"given":"Fernando","family":"Marqu\u00e9s\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department Donostia University Hospital  Donostia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5660-7955","authenticated-orcid":false,"given":"Cristina","family":"Mart\u00ednez\u2010Bravo","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1734-1954","authenticated-orcid":false,"given":"Isabel","family":"Aparicio\u2010Calvente","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6261-7711","authenticated-orcid":false,"given":"Laura","family":"Jim\u00e9nez\u2010A\u00f1on","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-7849","authenticated-orcid":false,"given":"Alba","family":"Leis\u2010Sestayo","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6954-0708","authenticated-orcid":false,"given":"Jennifer","family":"Rodr\u00edguez\u2010Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-1646","authenticated-orcid":false,"given":"Alicia","family":"Mart\u00ednez\u2010Iribarren","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0497-6003","authenticated-orcid":false,"given":"Cristian","family":"Morales\u2010Indiano","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department. Laboratori Cl\u00ednic Metropolitana Nord (LCMN) Germans Trias i Pujol University Hospital  Badalona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102012\u20100630"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.10.007"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102018\u20101323"},{"issue":"1","key":"e_1_2_12_5_1","first-page":"15","article-title":"Harmonization of Clinical Laboratory Information\u2014Current and Future Strategies","volume":"27","author":"Plebani M.","year":"2016","journal-title":"EJIFCC"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102023\u20100994"},{"key":"e_1_2_12_7_1","volume-title":"Medical Laboratories\u2014Requirements for Quality and Competence","author":"EN ISO 15189:2022","year":"2022"},{"key":"e_1_2_12_8_1","volume-title":"Verification of Comparability of Patient Results Within One Health Care System. CLSI document EP31\u2010A\u2010IR","author":"CLSI","year":"2012"},{"key":"e_1_2_12_9_1","volume-title":"Measurement Procedure Comparison and Bias Estimation Using Patient Samples. CLSI document EP09\u2010A3","author":"CLSI","year":"2013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2020.12.021"},{"key":"e_1_2_12_11_1","unstructured":"A. K.Aarsand P.Fernandez\u2010Calle C.Webster et\u00a0al. \u201cThe EFLM Biological Variation Database \u201daccessed Aug 2 2024 https:\/\/biologicalvariation.eu\/."},{"key":"e_1_2_12_12_1","unstructured":"J.Minchinela C.Ric\u00f3s C.Perich et\u00a0al. \u201cBiological Variation Database and Quality Specifications for Imprecision Bias and Total Error (Desirable and Minimum). The 2014 Update \u201daccessed Aug 18 2023 https:\/\/www.westgard.com\/biodatabase\u20102014\u2010update.htm."},{"key":"e_1_2_12_13_1","unstructured":"https:\/\/qapweb.beckmancoulter.com\/qapweb\/"},{"key":"e_1_2_12_14_1","volume-title":"Verification of Comparability of Patient Results Within One Health Care System. CLSI Guideline EP31","author":"CLSI","year":"2025"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102024\u20100108"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/9781444398595.ch54","volume-title":"Laboratory Hematology Practice","author":"Cembrowski G. S.","year":"2012"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.cll.2014.10.006","article-title":"Quality Control of Automated Cell Counters","volume":"35","author":"Cembrowski G. S.","year":"2015","journal-title":"Clinics in Laboratory Medicine"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.05.039"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1515\/cclm\u20102023\u20101495"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.15263\/jlmqa.2016.38.3.129"},{"key":"e_1_2_12_21_1","volume-title":"Textbook of Patient Safety and Clinical Risk Management","author":"Plebani M.","year":"2021"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2013.04.028"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.70243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijlh.70243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.70243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:24:21Z","timestamp":1789478661000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.70243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":21,"alternative-id":["10.1111\/ijlh.70243"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.70243","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"2026-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijlh.70243"}}