CLSI Promotes Global Harmonization of Clinical Laboratory Practices

The Clinical and Laboratory Standards Institute (CLSI) is a proven leader in the field of laboratory standards and guidelines-dedicated to developing best practices in clinical and laboratory testing and promoting their use throughout the world. CLSI is a volunteer-driven, membership-supported, nonprofit organization that promotes the development and use of voluntary standards and guidelines through a unique consensus process that involves stakeholders from health care professions, government, education, and industry. CLSI links professionals from around the world with a common purpose and mission. 

Ferruccio Ceriotti, MD, of Diagnostica E Ricerca San Raffaele in Milan, Italy, an International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) member and CLSI volunteer, agrees that the CLSI consensus process is valuable. He says, "I think the international participation on CLSI committees is important because it ensures that perspectives that may be different from those of the United States are represented. CLSI manages the process of collaboration and consensus quite well, which is reflected in the excellence of the results."

CLSI documents serve the medical laboratory community in several ways. The guidelines outline a pathway to standardization of laboratory practices that serves to improve quality, safety, and consistency, and at the same time, contains costs. Quality patient care begins with an accurate lab test, and CLSI documents lay the foundation for meeting that objective. Laboratory professionals use CLSI guidelines to meet requirements for regulatory compliance and accreditation. This is possible because regulatory agencies and accrediting bodies recognize the value of implementing CLSI standards and guidelines in establishing best practices that meet regulatory requirements. In addition, CLSI volunteers participate in Global Health Partnerships with the goal of improving health care around the world-specifically in resource-constrained countries that are bearing a heavy burden of disease.

CLSI documents do more than just serve as instruction manuals for laboratories; they also provide scientific explanations for procedures, and connect theory to practice for professionals. They also help professionals keep current with new technologies in areas such as molecular methods and point-of-care testing. Graham White, Associate Professor, SA Pathology, Flinders Medical Centre, Australia, and a CLSI volunteer, explains, "The regular appearance of new topics and updated editions of published documents in the CLSI library highlights the rapid pace of expansion and change taking place in laboratory medicine. CLSI documents provide theory and evidence that underpin the practical guidance. In this way, CLSI documents are not just recipe manuals for the bench, but they also educate laboratorians with a scientific understanding of the 'why' as well as the 'how.'"

International Focus and Shared Goals

IFCC and CLSI are proud of their nearly decade-long partnership aimed at promoting global harmonization of clinical laboratory practices. The partnership has lead to the development of several consensus standards and guidelines that meet the goals of all CLSI documents to reflect a global perspective, help to improve the quality of laboratory results, and ultimately improve patient care. 
The partnership of IFCC and CLSI grew out of the recognition of shared goals and a mutual focus of interest. IFCC's involvement in CLSI's projects is one of the many important relationships with organizations and societies in the health care field that CLSI supports to ensure that a broad international perspective is maintained in its products and services. In addition, both organizations are dedicated to assisting developing countries in improving analytical results and helping those nations learn about better and more efficient approaches to clinical chemistry and laboratory practice.
Graham White notes the growing importance of consistency in clinical laboratories worldwide, saying, "Increasing mobility of patients and doctors within and between health care systems, and expanding use of international clinical guidelines for diagnosing and managing disease, are increasing the need for clinical laboratories to provide, for any given test, high quality results that are comparable over time, regardless of the method and laboratory used. The collaborations between CLSI and IFCC bring together the broadest available expertise to generate unified best practice evidence-based guidelines, procedures, and documents that, when widely implemented, provide the practical framework for achieving high quality consistency across routine clinical laboratories, wherever they are located."

IFCC and CLSI have also partnered with the National Institute of Standards and Technology (NIST) to sponsor the IFCC/NIST/CLSI Robert Schaffer Award for Outstanding Achievements in the Development of Standards for Use in Laboratory Medicine. Professor Lothar Siekmann, PhD, was selected to receive the first award, which honors an individual who has made unique contributions to the advancement of reference methods and/or reference materials for laboratory medicine. Dr. Siekmann is Professor of Clinical Chemistry of the Medical Faculty of the University of Bonn, Germany, and Director of the Reference Laboratory I of the German Society of Clinical Chemistry (DGKL).

IFCC/CLSI Documents

There are several joint IFCC/CLSI documents in the CLSI library that demonstrate the benefits of an international approach to clinical chemistry. Examples include the following:
C28-A3 - Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline-Third Edition contains guidelines for determining reference values and reference intervals for quantitative clinical laboratory tests.
C49-A - Analysis of Body Fluids in Clinical Chemistry; Approved Guideline provides guidance for the application of widely available measurement procedures for testing body fluids and for reporting and interpreting those results.
X05-R - Metrological Traceability and Its Implementation; A Report provides guidance to manufacturers for establishing and reporting metrological traceability.
EP17-A - Protocols for Determination of Limits of Detection and Limits of Quantitation; Approved Guideline provides guidance for determining the lower limit of detection of clinical laboratory methods, for verifying claimed limits, and for the proper use and interpretation of the limits.

This is just a partial list of the types of useful projects that IFCC and CLSI have produced. 

Become a Member of CLSI

There are many ways to become a part of the CLSI membership community. CLSI has several membership options to meet the needs of organizations, professional societies, and associations. CLSI members consist of organizations rather than individual members. Membership in CLSI ensures that members' needs are addressed in the standards and guidelines they use daily. Additionally, membership provides the opportunity to network with representatives from government, industry, and the health care professions, as well as colleagues in related disciplines while working collaboratively to develop solutions to relevant issues. Membership dues help support standards and guidelines that directly impact the delivery of quality patient care. All members receive a savings of up to 50% on standards and guidelines.
Volunteering with CLSI is a way to join the more than 2, 000 experts from around the world involved in the development of documents using the consensus process. Graham White believes his time as a CLSI volunteer has been rewarding, adding, "The value of an individual's expertise can remain local unless harnessed and made available to the global clinical laboratory community, and major enablers of this are professional societies such as CLSI and IFCC. By offering volunteers many opportunities to contribute their expertise in participating in the development and/or revision of consensus standards and guidelines, commenting on draft documents, participating in presentations on implementation of best laboratory practices, and in many other ways, laboratorians can significantly contribute to the advancement of their professional discipline and the improvement of global health."
Visit www.clsi.org for more information about membership and to learn more about the more than 200 products offered by CLSI.