The Interlaboratory Comparison Program (ICP) is modeled after the successful CAP FP Survey, with 5 serum samples distributed 3 times per year. The challenges consist of 1 mL aliquots of real patient serum pools and manufactured samples that have tested negative for infectious diseases (Hep B surface antigen, Hep C antibody and HIV Ag/A combination). Initially, only PAPP-A and hCG were evaluated, but beginning with the third distribution in 2008 (FT-C), we now also offer the option of measuring PAPP-A and free beta hCG for those labs using this combination for their first trimester screen. Information about nuchal translucency accompanies the patient history to allow for validation of Down syndrome risks. Every distribution also includes an educational component based on supplemental questions linked to the ICP results. Examples of educational components include maternal weight and racial adjustments, trisomy 18 screening, assessment of equations used to calculate gestational age, and screening for twin pregnancies. We also provide external review of integrated risks by combining information from the CAP FP Survey with ICP results (needed for integrated, sequential or contingent screening).
A sample reporting form that includes clinical histories and a listing of manufactured kits used by ICP participants is available (http://www.ipmms.org/ICP/2009%20FT-C%20Data%20Form.pdf). The registration form is also available on our web site. The yearly participant cost is $700 (January through December) – payable in advance.
The program is administered by members of the Department of Pathology and Laboratory Medicine at Women & Infants Hospital of Rhode Island and Alpert Medical School of Brown University. Staff includes members of the Division of Medical Screening and Special Testing at Woman’s and Infants Hospital. George Knight and Glenn Palomaki initiated and administered an interlaboratory program for AFP and multiple markers beginning in the early 1980s, and in the late 1980s that program was merged with the CAP FP Survey. Jack Canick and Geralyn Lambert-Messerlian directed the first academic program to offer triple and quad testing in the US and recently served as the testing center for the FASTER trial. This latter activity provides special insight into how the laboratory might interact with sonographers providing NT measurements.
The operating philosophy is collegial: laboratories, manufacturers and other interested parties collectively share data with a view towards standardizing and improving the practice of first trimester screening. If you have any questions, please feel free to contact us. If you know of others who may be interested, please let them know about this program.
George J. Knight, Ph.D., Glenn E. Palomaki, Ph.D.: (207) 894-6610
Jacob A. Canick, Ph.D., Geralyn M. Messerlian, Ph.D: (401) 453-7650
Department of Pathology and Laboratory Medicine
Women & Infants Hospital, Providence, Rhode Island