Quality assessment

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<p>This link leads you to the <strong>German version</strong> "<a href="/index.php?title=RiliB%C3%84K%20zu%20Ejakulatuntersuchungen">RiliB&Auml;K</a>".</p>
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<td><img src="/images/plus48.png" alt="" width="48" height="48" /></td>
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<td><a href="/index.php?title=RiliB%C3%84K%20zu%20Ejakulatuntersuchungen">Click here</a> to read the German version "RiliB&Auml;K".</td>
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</tr>
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</tbody>
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</table>
 
<p>&nbsp;</p>
 
<p>&nbsp;</p>
 
<h2>Quality assessment settings</h2>
 
<h2>Quality assessment settings</h2>
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<p>Before using <strong>Quality assessment</strong>, check the basic parameters in the settings of MedITEX IVF and adjust if needed.</p>
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<p>Before using <strong>Quality assessment</strong>, check the basic parameters in the <a href="/index.php?title=MedITEX_IVF_Settings#Semen_analysis">settings</a> of MedITEX IVF.</p>
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<table border="0">
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<table style="margin-left: auto; margin-right: auto;" border="0">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td><img src="/images/QM1.png" alt="" width="508" height="119" /></td>
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<td><img src="/images/QM001.png" alt="" /><br /></td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
 
<ul>
 
<ul>
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<li>You access settings via the menu <strong>System -&gt; Configuration / administration -&gt; Settings</strong> on the top of the window.</li>
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<li>You can access the settings from the menu <strong>System -&gt; Configuration / administration -&gt; Settings</strong> on the top of the window.</li>
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<li>In the settings you go to <strong>System -&gt; Functions -&gt; Semen analysis</strong> to Quality assessment-default settings and check <strong>"Activate / deactivate Qualitiy assessment</strong>".</li>
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<li>Go to <strong>System -&gt; Functions -&gt; Semen analysis</strong> and check <strong>Activate / deactivate Quality assessment</strong>.</li>
 
</ul>
 
</ul>
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<table border="0">
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<table style="margin-left: auto; margin-right: auto;" border="0" width="448" height="457">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td>[[Image:QM2.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM2.png| ]]</td>
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<td><img src="/images/QM02.png" alt="" width="532" height="487" /><br /></td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
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<p>&nbsp;</p>
 
<p>As number of differentiating cells for <strong>motility </strong>and <strong>morphology </strong>by default <strong>200 sperm</strong> are set. This number is the minimum value that is to be counted according to the directive per sperm count.</p>
 
<p>As number of differentiating cells for <strong>motility </strong>and <strong>morphology </strong>by default <strong>200 sperm</strong> are set. This number is the minimum value that is to be counted according to the directive per sperm count.</p>
 
<p>Also the specification of the <strong>workplace</strong>, the <strong>examination </strong>and the <strong>method </strong>should be entered here. The data will be <strong>automatically </strong>transferred to your Quality assessment entry screen.</p>
 
<p>Also the specification of the <strong>workplace</strong>, the <strong>examination </strong>and the <strong>method </strong>should be entered here. The data will be <strong>automatically </strong>transferred to your Quality assessment entry screen.</p>
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<p>The <strong>dilution </strong>or<strong> enrichment of the ejaculate</strong> and / or the number of the counting fields must be selected in accordance with an orienting preliminary examination. If the sperm concentration is less than 1-2 sperm per high power field (objective magnification 40-fold), <strong>the sample should be enriched</strong>. Finds then <strong>less than 200 sperm per counting grid</strong> of the counting chamber, <strong>eliminates the requirement of at least 2 x 200 to be counted spermatozoa</strong>.</p>
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<p>The <strong>dilution </strong>or<strong> enrichment of the ejaculate</strong> and / or the number of the counting fields must be selected in   accordance with an orienting preliminary examination. If the sperm   concentration is less than 1-2 sperm per high power field (objective   magnification 40-fold), <strong>the sample should be enriched</strong>. Finds then <strong>less than 200 sperm per counting grid</strong> of the counting chamber, <strong>eliminates the requirement of at least 2 x 200 to be counted spermatozoa</strong>.</p>
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<p>These settings will be loaded on every Quality assessment calculation as default values ​​and can be edited in addition, depending on the special case.</p>
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<p>These settings will be loaded on every Quality assessment calculation   as default values ​​and can be edited in addition, depending on the   special case.</p>
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<p>&nbsp;</p>
 
<h2>Using Quality assessment</h2>
 
<h2>Using Quality assessment</h2>
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<p>The Quality assessment functionality, you use at the menu item <strong>"Laboratory diagnosis"</strong> of the male patients in which you create a new semen analysis by using the button <strong>"New sample"</strong>.</p>
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<p>The <strong>Quality assessment</strong> functionality is used when conducting a <strong>Semen analysis</strong>. From a male patient window, select <strong>Lab. diagnosis</strong>. From the new window, click on <strong>New sample </strong>and choose <strong>Semen analysis</strong>.</p>
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<table border="0">
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<table style="margin-left: auto; margin-right: auto;" border="0">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
 
<td><img src="/images/QM3.png" alt="" width="279" height="329" /></td>
 
<td><img src="/images/QM3.png" alt="" width="279" height="329" /></td>
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<td><img src="/images/QM4.png" alt="" width="255" height="262" /></td>
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<td><img src="/images/QM4.png" alt="" /></td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
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<p><strong>Examinations </strong>can be carried out either <strong>manually </strong>or <strong>automatically </strong>(CASA = Sperm class analyzer).<br /><br />The <strong>examination </strong>of the spermatozoa in a counting chamber is separated according to</p>
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<p>&nbsp;</p>
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<p><strong>Examinations </strong>can be conducted either <strong>manually </strong>or <strong>automatically </strong>(CASA = Sperm class analyzer).<br /><br />The <strong>examination </strong>of sperms in a counting chamber is separated according to</p>
 
<ol>
 
<ol>
 
<li><strong>Concentration </strong>(number),</li>
 
<li><strong>Concentration </strong>(number),</li>
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<li><strong>Morphology </strong>(normal or abnormal in percent)</li>
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<li><strong>Morphology </strong>(normal or abnormal percentage)</li>
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<li> <strong>Motility </strong>(movement in 3 stages: progressive movement, locally movable immotil in percent)</li>
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<li> <strong>Motility </strong>(movement in 3 stages: progressive movement, locally movable immotile percentage)</li>
 
</ol>
 
</ol>
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<p>performed in <strong>duplicate determinations</strong>, <strong>evaluated </strong>and <strong>documented</strong>.</p>
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<p>These are performed in <strong>duplicate determinations</strong> then <strong>evaluated </strong>and <strong>documented</strong>.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
 
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<tr>
 
<tr>
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</tbody>
 
</tbody>
 
</table>
 
</table>
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<p style="text-align: center;">This form is<strong> no direct data entry</strong> in fields<br /><br />Concentration<br />Motility and<br />Morphology<br /><br />possible, because a <strong>duplicate determination</strong> is required.</p>
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<p style="text-align: left;">&nbsp;</p>
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<table border="0">
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<p style="text-align: left;">If you check the box <strong>Use quality assessment</strong>, the <strong>Concentration</strong>, <strong>Motility </strong>and <strong>Morphology</strong> fields will not be able to be entered on this window. This method requires a new way for the calculation.</p>
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<p style="text-align: left;">Switch to the <strong>Quality assessment </strong>tab to input the data.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td>[[Image:QM6.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM6.png| ]]</td>
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<td><img src="/images/QM6.png" alt="" width="558" height="442" /></td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
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<p>The <strong>examintaions </strong>are independent according to the <strong>quantity mass</strong> and can be <strong>evaluated separately</strong>.</p>
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<p>&nbsp;</p>
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<h2>Execution - investigation concentration</h2>
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<p>The <strong>examinations </strong>are independent and may change according to the <strong>parameters</strong>. They can also be <strong>evaluated separately</strong>.</p>
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<p>To add a <strong>count </strong>with <strong>duplicate determination</strong> go to the tab <strong>Quality assessment-&gt; Sperm counts</strong>.</p>
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<p>&nbsp;</p>
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<p>The <strong>duplicate determination of the concentration</strong> is carried out as follows:</p>
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<h2>Examining the concentration</h2>
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<p>Switch to the tab <strong>Quality assessment -&gt; Sperm counts</strong>.</p>
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<p>In order to calculate the concentration, folow these steps:</p>
 
<ol>
 
<ol>
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<li>A counting chamber is filled with the sample.</li>
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<li>Fill the counting chamber with the sample;</li>
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<li>Subsequently, the two halves of counting chambers are evaluated separately. <strong>Each counting chamber is one of the duplicate determinations!</strong></li>
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<li>The two halves of counting chambers are examined separately. Each one accounts for a separate analysis: <strong>no 1 </strong>and <strong>no 2.</strong></li>
 
</ol>  
 
</ol>  
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<table border="0" width="587" height="68">
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<table style="margin-left: auto; margin-right: auto;" border="0" width="525" height="496">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td>[[Image:QM7.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM7.png| ]]</td>
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<td><img src="/images/QM7.png" alt="" width="586" height="452" /><br /></td>
 
</tr>
 
</tr>
 
<tr>
 
<tr>
 
<td>
 
<td>
 
<ul>
 
<ul>
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<li>Concentration: 1. counting chamber, 2. counting chamber</li>
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<li>Concentration: 1st counting chamber, 2nd counting chamber</li>
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<li>Concentration calculator</li>
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</ul>
 
</ul>
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<p>Pay attention to your chosen unit. If necessary, the settings of the concentration counter (Result tab) have to be adjusted.</p>
 
</td>
 
</td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
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<h2>Execution - investigation motility &amp; morphology</h2>
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<p>&nbsp;</p>
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<p>In the <strong>duplicate determinations</strong> at least <strong>2x200 sperm</strong> have to be evaluated. If the number of sperm less than 200/visulal field <strong>after enrichment</strong>, the requirement is not relevant and a <strong>smaller number</strong> has to be evaluated.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0" width="32" height="24">
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<tbody>
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<tr>
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<td style="text-align: center;"><img src="/images/QM28.png" alt="" width="583" height="449" /></td>
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</tr>
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</tbody>
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</table>
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<p>&nbsp;</p>
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<p>&nbsp;</p>
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<h2 style="text-align: left;">Exemaning the motility and morphology</h2>
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<p>When using quality assessment, at least <strong>400 </strong>sperms need to be counted. 200 from the <strong>first </strong>chamber and another 200 for the <strong>second</strong>. If the number of sperms are less than 200, the counting may proceed with a <strong>smaller </strong>quantity.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
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<tr>
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<td><img src="/images/QM8.png" alt="" width="558" height="442" /></td>
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</tr>
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</tbody>
 +
</table>
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<p>&nbsp;</p>
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<h3>Motility</h3>
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<p>The <strong>examination </strong>carried on the sperm, identifies its <strong>motility</strong>: <strong>progressive motile</strong>, <strong>locally motile</strong> and <strong>immotile</strong><strong>&nbsp;</strong>.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
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<tr>
 +
<td><img src="/images/QM9.png" alt="" width="558" height="442" /></td>
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</tr>
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</tbody>
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</table>
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<p>&nbsp;</p>
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<p><em>Note: for <strong>Germany</strong>, the values ​​of <strong>WHO A</strong> and <strong>WHO B</strong> must be calculated separately according to the <strong>DIR</strong> regulations!</em></p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
 +
<tr>
 +
<td><img src="/images/motcount1.png" alt="" width="435" height="572" /></td>
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</tr>
 +
</tbody>
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</table>
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<p>&nbsp;</p>
 
<table border="0">
 
<table border="0">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td>[[Image:QM8.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM8.png| ]]</td>
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<td><a href="/index.php?title=Semen_counter"><img src="/images/plus48.png" alt="" width="48" height="48" /></a></td>
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<td>In order to make this process faster, <strong>MedITEX IVF</strong> offers three calculators at the semen analysis input mask. Click <a href="/index.php?title=Semen_counter">here</a>, for more information.</td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
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<p><strong>Investigation motility</strong></p>
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<p>&nbsp;</p>
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<p>The <strong>examination </strong>of the sperm is to perform with <strong>motility </strong>(movement in 3 stages:<strong> progressive movement</strong>, <strong>locally movable</strong> and <strong>immotil </strong>in percent) in <strong>duplicate determinations</strong>.</p>
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<h3>Morphology</h3>
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<p>The <strong>examination </strong>of sperm <strong>morphology </strong>needs to be carried out for<strong> both analysis</strong>.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
 +
<tr>
 +
<td><img src="/images/QM11.png" alt="" width="558" height="442" /></td>
 +
</tr>
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</tbody>
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</table>
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<p>&nbsp;</p>
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<h2>Documentation</h2>
 
<table border="0">
 
<table border="0">
 
<tbody>
 
<tbody>
 
<tr>
 
<tr>
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<td>[[Image:QM9.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM9.png| ]]</td>
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<td colspan="2"><img src="/images/QM12.png" alt="" width="558" height="442" /></td>
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</tr>
 +
<tr>
 +
<td><img src="/images/plus48.png" alt="" width="48" height="48" /></td>
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<td>
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<p>You can edit the options of the <strong>workplace and the unit </strong>in the settings under <a href="/index.php?title=MedITEX_IVF_Settings#System_tables">system tables</a>.</p>
 +
</td>
 
</tr>
 
</tr>
 
</tbody>
 
</tbody>
 
</table>
 
</table>
 
<p>&nbsp;</p>
 
<p>&nbsp;</p>
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<h2>Result</h2>
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<p><strong>The evaluation of results</strong> have to be made <strong>immediately after</strong> the completion of the examination.</p>
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<p>Please open the second tab <strong>Result</strong><strong>&nbsp;</strong>.</p>
 
<p>&nbsp;</p>
 
<p>&nbsp;</p>
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<h3>Result of the sperm concentration</h3>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
 +
<tr>
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<td colspan="2"><img src="/images/QM28.png" alt="" width="583" height="449" /></td>
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</tr>
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<tr>
 +
<td colspan="2">
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<ul>
 +
<li>N1 = number, 1. Counting</li>
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<li>N2 = number, 2. Counting</li>
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</ul>
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<ul>
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<li>AVG = average = (N1 + N2):2</li>
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<li>d = difference = |N1 - N2|</li>
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</ul>
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</td>
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</tr>
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<tr>
 +
<td><img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" /></td>
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<td>If the difference is greater than the formula value,<br />the release can not be effected. The procedure will have to be redone.</td>
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</tr>
 +
</tbody>
 +
</table>
 
<p>&nbsp;</p>
 
<p>&nbsp;</p>
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<h3>Result of the sperm motility</h3>
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<table style="margin-left: auto; margin-right: auto;" border="0">
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<tbody>
 +
<tr>
 +
<td colspan="2"><img src="/images/QM16.png" alt="" width="555" height="444" /></td>
 +
</tr>
 +
<tr>
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<td colspan="2">
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<ul>
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<li>N = number of different sperms</li>
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<li>P1 = <span id="result_box" class="short_text" lang="en"><span class="hps">percentage of the</span> <span class="hps">first</span> <span class="hps">count</span></span></li>
 +
<li>P2 = <span id="result_box" class="short_text" lang="en"><span class="hps">percentage of the</span> second <span class="hps">count</span></span></li>
 +
<li>AVG = average = (N1 + N2):2</li>
 +
<li>d = difference = |N1 - N2|</li>
 +
</ul>
 +
<p><strong><span style="text-decoration: underline;">Assessment</span>: d &le; 1,96 * sqrt( 2 * MW * (100-MW) : N )</strong></p>
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</td>
 +
</tr>
 +
<tr>
 +
<td><img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" width="119" height="88" /></td>
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<td>If the difference is greater than the formula value,<br />the release can not be effected. The procedure will have to be redone.</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p>&nbsp;</p>
 +
<h3>Result of the motility</h3>
 +
<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td colspan="2"><img src="/images/QM17.png" alt="" width="555" height="444" /></td>
 +
</tr>
 +
<tr>
 +
<td colspan="2">
 +
<ul>
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<li>N = number of differnent sperms</li>
 +
<li>P1 = <span id="result_box" class="short_text" lang="en"><span class="hps">percentage of the</span> <span class="hps">first</span> <span class="hps">count</span></span></li>
 +
<li>P2 = <span id="result_box" class="short_text" lang="en"><span class="hps">percentage of the</span> second <span class="hps">count</span></span></li>
 +
<li>AVG = average = (N1 + N2):2</li>
 +
<li>d = difference (absolut) = |N1 - N2|</li>
 +
</ul>
 +
<p><strong><span style="text-decoration: underline;">Assessment</span>: d &le; 1,96 * sqrt( 2 * MW * (100-MW) : N )</strong></p>
 +
<br /></td>
 +
</tr>
 +
<tr>
 +
<td><img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" width="119" height="88" /></td>
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<td>If the difference is greater than the formula value,<br />the release can not be effected. The procedure will have to be redone.</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p>&nbsp;</p>
 +
<h2>Current validation</h2>
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<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td><img src="/images/QM29.png" alt="" /></td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p>This display shows you the <strong>current trend of long-term validation</strong>. To receive more information, <strong>move your mouse over the colored dot</strong>.<br /><br />The exact calculation of the current validationyou can find in the menu under<strong> Reports -&gt; Semen analysis quality assessment</strong>.</p>
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<p>&nbsp;</p>
 +
<p>&nbsp;</p>
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<h2>Semen analysis quality assessment</h2>
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<p>Every month, after achieving an amount of&nbsp;<strong>50 semen analysis</strong> or more, you must generate a <strong>long-term validation</strong>.</p>
 +
<p><span id="result_box" lang="en"><span class="hps">Click</span> on <span class="hps"><strong>Reports -&gt;</strong></span><strong> <span class="hps">Semen analysis quality assessment</span></strong><span class="hps">.</span></span></p>
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<p><span lang="en"><span class="hps">&nbsp;</span></span></p>
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<table border="0">
 +
<tbody>
 +
<tr>
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<td colspan="2"><img style="display: block; margin-left: auto; margin-right: auto;" src="/images/QM18.png" alt="" /></td>
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</tr>
 +
<tr>
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<td><img src="/images/hint48.png" alt="" width="48" height="48" /></td>
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<td>It is possible that you have no permission for using this area. <br />Please ask your system admin.<br />Permissions can be set by users with admin rights in the <a href="/index.php?title=Administration_of_user#Administration_of_user_rights">administration tool</a>.</td>
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</tr>
 +
</tbody>
 +
</table>
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<p><span lang="en"><span class="hps"><br /></span></span></p>
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<h3>Long-term validation preparation</h3>
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<p>All results of the quality assessment are documented separately by <strong>parameter </strong>and <strong>workplace</strong>.</p>
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<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td>[[Image:QM200.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM200.png| ]]</td>
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</tr>
 +
<tr>
 +
<td>
 +
<p><strong>First step</strong>: select a parameter and a workplace</p>
 +
<p>Parameters:</p>
 +
<ul>
 +
<li>Concentration;</li>
 +
<li>Motility WHO AB;</li>
 +
<li>Motility WHO C;</li>
 +
<li>Motility WHO D;</li>
 +
<li>Morphology.</li>
 +
</ul>
 +
</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td>[[Image:QM21.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM21.png| ]]</td>
 +
</tr>
 +
<tr>
 +
<td><strong>Second step</strong>: evaluation of all duplicate determinations<br /><br />
 +
<ul>
 +
<li>per parameter</li>
 +
<li>per workplace</li>
 +
</ul>
 +
</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td>[[Image:QM22.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM22.png| ]]</td>
 +
</tr>
 +
<tr>
 +
<td><strong>Third step</strong>: flowing assessment/ current assessment<br /><br />&nbsp;&nbsp;&nbsp;&nbsp; n = number of results<br />&nbsp;&nbsp;&nbsp;&nbsp; d = difference<br />&nbsp;&nbsp;&nbsp;&nbsp; MWd = mean deviation = 1: n * Sum (d)<br />&nbsp;&nbsp;&nbsp;&nbsp; Sd = standard deviation of the difference = sqrt (1: (n-1) * Sum ([d MWd] 2))<br /><br /><strong>Assessment: MWd &le; 1.96 * sd: sqrt (n)</strong></td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td>[[Image:QM23.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM23.png| ]]</td>
 +
</tr>
 +
<tr>
 +
<td>
 +
<p><strong>Fourth step</strong>: control period / 50 analysis</p>
 +
</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p><em>Note: after reaching the 50 analysis for the given control period, you will be reminded to perform the long-term validation.</em></p>
 +
<table style="margin-left: auto; margin-right: auto;" border="0" width="662" height="74">
 +
<tbody>
 +
<tr>
 +
<td>[[Image:QM26.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM26.png| ]]</td>
 +
</tr>
 +
<tr>
 +
<td><strong>Fifth step</strong>: long-term validation<br /><br /><strong>The long-term validation is to be performed individually for each parameter!</strong></td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p>&nbsp;</p>
 +
<p>If the <strong>Mean value</strong> of the difference is<strong> greater </strong>than the formula value, no results will be issued <strong>until the cause is cleared and removed</strong>. The process must be <strong>documented</strong>. The fields <strong>cause, corrective action, eliminated</strong> and <strong>person (correction)</strong> need to be filled.<strong>&nbsp;</strong></p>
 +
<table style="margin-left: auto; margin-right: auto;" border="0">
 +
<tbody>
 +
<tr>
 +
<td>&nbsp;[[Image:QM27.png|none|740px|thumb|left|link=http://wiki.meditex-software.com/images/QM27.png| ]]</td>
 +
</tr>
 +
<tr>
 +
<td>In the upper half of this window, you can see<strong> </strong>the <strong>results </strong>of the long-term validation for a<strong> parameter </strong>or a <strong>workplace</strong>.<br /><br />Below, there is a list of the <strong>Single results</strong>. The associated semen analysis can be viewed by a <strong>double</strong> or <strong>right-click</strong>.</td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<table style="float: right;" border="0">
 +
<tbody>
 +
<tr>
 +
<td style="text-align: right;"><a href="/index.php?title=MedITEX_IVF_manual">Back to the MedITEX IVF menu </a></td>
 +
<td style="text-align: right;"><a href="#top">Back to top</a></td>
 +
</tr>
 +
</tbody>
 +
</table>
 +
<p><span class="mw-headline"><br /></span></p>

Latest revision as of 13:07, 29 May 2013

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<img src="/images/plus48.png" alt="" width="48" height="48" /> <a href="/index.php?title=RiliB%C3%84K%20zu%20Ejakulatuntersuchungen">Click here</a> to read the German version "RiliBÄK".

 

Contents

Quality assessment settings

Before using Quality assessment, check the basic parameters in the <a href="/index.php?title=MedITEX_IVF_Settings#Semen_analysis">settings</a> of MedITEX IVF.

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<img src="/images/QM001.png" alt="" />
  • You can access the settings from the menu System -> Configuration / administration -> Settings on the top of the window.
  • Go to System -> Functions -> Semen analysis and check Activate / deactivate Quality assessment.
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<img src="/images/QM02.png" alt="" width="532" height="487" />

 

As number of differentiating cells for motility and morphology by default 200 sperm are set. This number is the minimum value that is to be counted according to the directive per sperm count.

Also the specification of the workplace, the examination and the method should be entered here. The data will be automatically transferred to your Quality assessment entry screen.

The dilution or enrichment of the ejaculate and / or the number of the counting fields must be selected in accordance with an orienting preliminary examination. If the sperm concentration is less than 1-2 sperm per high power field (objective magnification 40-fold), the sample should be enriched. Finds then less than 200 sperm per counting grid of the counting chamber, eliminates the requirement of at least 2 x 200 to be counted spermatozoa.

These settings will be loaded on every Quality assessment calculation as default values ​​and can be edited in addition, depending on the special case.

 

Using Quality assessment

The Quality assessment functionality is used when conducting a Semen analysis. From a male patient window, select Lab. diagnosis. From the new window, click on New sample and choose Semen analysis.

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<img src="/images/QM3.png" alt="" width="279" height="329" /> <img src="/images/QM4.png" alt="" />

 

Examinations can be conducted either manually or automatically (CASA = Sperm class analyzer).

The examination of sperms in a counting chamber is separated according to

  1. Concentration (number),
  2. Morphology (normal or abnormal percentage)
  3. Motility (movement in 3 stages: progressive movement, locally movable immotile percentage)

These are performed in duplicate determinations then evaluated and documented.

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QM5.png

 

If you check the box Use quality assessment, the Concentration, Motility and Morphology fields will not be able to be entered on this window. This method requires a new way for the calculation.

Switch to the Quality assessment tab to input the data.

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<img src="/images/QM6.png" alt="" width="558" height="442" />

 

The examinations are independent and may change according to the parameters. They can also be evaluated separately.

 

Examining the concentration

Switch to the tab Quality assessment -> Sperm counts.

In order to calculate the concentration, folow these steps:

  1. Fill the counting chamber with the sample;
  2. The two halves of counting chambers are examined separately. Each one accounts for a separate analysis: no 1 and no 2.
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<img src="/images/QM7.png" alt="" width="586" height="452" />
  • Concentration: 1st counting chamber, 2nd counting chamber

Pay attention to your chosen unit. If necessary, the settings of the concentration counter (Result tab) have to be adjusted.

 

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<img src="/images/QM28.png" alt="" width="583" height="449" />

 

 

Exemaning the motility and morphology

When using quality assessment, at least 400 sperms need to be counted. 200 from the first chamber and another 200 for the second. If the number of sperms are less than 200, the counting may proceed with a smaller quantity.

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<img src="/images/QM8.png" alt="" width="558" height="442" />

 

Motility

The examination carried on the sperm, identifies its motility: progressive motile, locally motile and immotile .

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<img src="/images/QM9.png" alt="" width="558" height="442" />

 

Note: for Germany, the values ​​of WHO A and WHO B must be calculated separately according to the DIR regulations!

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<img src="/images/motcount1.png" alt="" width="435" height="572" />

 

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<a href="/index.php?title=Semen_counter"><img src="/images/plus48.png" alt="" width="48" height="48" /></a> In order to make this process faster, MedITEX IVF offers three calculators at the semen analysis input mask. Click <a href="/index.php?title=Semen_counter">here</a>, for more information.

 

Morphology

The examination of sperm morphology needs to be carried out for both analysis.

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<img src="/images/QM11.png" alt="" width="558" height="442" />

 

Documentation

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<img src="/images/QM12.png" alt="" width="558" height="442" />
<img src="/images/plus48.png" alt="" width="48" height="48" />

You can edit the options of the workplace and the unit in the settings under <a href="/index.php?title=MedITEX_IVF_Settings#System_tables">system tables</a>.

 

Result

The evaluation of results have to be made immediately after the completion of the examination.

Please open the second tab Result .

 

Result of the sperm concentration

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<img src="/images/QM28.png" alt="" width="583" height="449" />
  • N1 = number, 1. Counting
  • N2 = number, 2. Counting
  • AVG = average = (N1 + N2):2
  • d = difference = |N1 - N2|
<img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" /> If the difference is greater than the formula value,
the release can not be effected. The procedure will have to be redone.

 

Result of the sperm motility

<tbody> </tbody>
<img src="/images/QM16.png" alt="" width="555" height="444" />
  • N = number of different sperms
  • P1 = percentage of the first count
  • P2 = percentage of the second count
  • AVG = average = (N1 + N2):2
  • d = difference = |N1 - N2|

Assessment: d ≤ 1,96 * sqrt( 2 * MW * (100-MW) : N )
<img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" width="119" height="88" /> If the difference is greater than the formula value,
the release can not be effected. The procedure will have to be redone.

 

Result of the motility

<tbody> </tbody>
<img src="/images/QM17.png" alt="" width="555" height="444" />
  • N = number of differnent sperms
  • P1 = percentage of the first count
  • P2 = percentage of the second count
  • AVG = average = (N1 + N2):2
  • d = difference (absolut) = |N1 - N2|

Assessment: d ≤ 1,96 * sqrt( 2 * MW * (100-MW) : N )
<img style="display: block; margin-left: auto; margin-right: auto;" src="/images/Q15.png" alt="" width="119" height="88" /> If the difference is greater than the formula value,
the release can not be effected. The procedure will have to be redone.

 

Current validation

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<img src="/images/QM29.png" alt="" />

This display shows you the current trend of long-term validation. To receive more information, move your mouse over the colored dot.

The exact calculation of the current validationyou can find in the menu under Reports -> Semen analysis quality assessment.

 

 

Semen analysis quality assessment

Every month, after achieving an amount of 50 semen analysis or more, you must generate a long-term validation.

Click on Reports -> Semen analysis quality assessment.

 

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<img style="display: block; margin-left: auto; margin-right: auto;" src="/images/QM18.png" alt="" />
<img src="/images/hint48.png" alt="" width="48" height="48" /> It is possible that you have no permission for using this area.
Please ask your system admin.
Permissions can be set by users with admin rights in the <a href="/index.php?title=Administration_of_user#Administration_of_user_rights">administration tool</a>.


Long-term validation preparation

All results of the quality assessment are documented separately by parameter and workplace.

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QM200.png

First step: select a parameter and a workplace

Parameters:

  • Concentration;
  • Motility WHO AB;
  • Motility WHO C;
  • Motility WHO D;
  • Morphology.
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QM21.png
Second step: evaluation of all duplicate determinations

  • per parameter
  • per workplace
<tbody> </tbody>
QM22.png
Third step: flowing assessment/ current assessment

     n = number of results
     d = difference
     MWd = mean deviation = 1: n * Sum (d)
     Sd = standard deviation of the difference = sqrt (1: (n-1) * Sum ([d MWd] 2))

Assessment: MWd ≤ 1.96 * sd: sqrt (n)
<tbody> </tbody>
QM23.png

Fourth step: control period / 50 analysis

Note: after reaching the 50 analysis for the given control period, you will be reminded to perform the long-term validation.

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QM26.png
Fifth step: long-term validation

The long-term validation is to be performed individually for each parameter!

 

If the Mean value of the difference is greater than the formula value, no results will be issued until the cause is cleared and removed. The process must be documented. The fields cause, corrective action, eliminated and person (correction) need to be filled. 

<tbody> </tbody>
 
QM27.png
In the upper half of this window, you can see the results of the long-term validation for a parameter or a workplace.

Below, there is a list of the Single results. The associated semen analysis can be viewed by a double or right-click.
<tbody> </tbody>
<a href="/index.php?title=MedITEX_IVF_manual">Back to the MedITEX IVF menu </a> <a href="#top">Back to top</a>