Unlocking the Power of Urinary Tests in China

China has been on a mission to improve the diagnosis of inherited metabolic disorders (IMDs) in newborns. The focus has been on urinary organic acid analysis. This type of testing is vital for spotting these disorders early. A five-year plan was put into action to standardize how these tests are done across the country. The plan started in 2019 and wrapped up in 2023. It was all about making sure labs were on the same page. The goal was to reduce mistakes and ensure accurate results. This was done through a program called the EQA scheme. The scheme used gas chromatography-mass spectrometry (GC-MS). This advanced tool helps in detecting tiny amounts of organic acids in urine. Over the five years, the number of labs taking part grew from 43 to 76. That's a big jump! Most labs stuck with the program, showing a median participation rate of 94. 74%. The scheme looked at eight key organic acid metabolites. These are substances that can indicate if a baby has an IMD. The results showed that the program worked. The variation in test results went down significantly over time. This means labs were getting more consistent and accurate. There were some differences in how well labs performed based on where they were located. But by the end of the program, these gaps had narrowed. Labs that used extraction methods for sample preparation did better than those that didn't. This shows that the method used can make a big difference in test results. Newborn Screening Centers (NBSCs) also showed better performance. They had lower variation in their results compared to other labs. The program was especially helpful for labs in central and western China. These regions saw big improvements in their testing quality. So, what's next? The plan is to get even more labs involved, especially those in areas that haven't been reached yet. The focus will also be on adding more tests to check not just the quantity but also the quality of lab performance. It's clear that standardized protocols and continuous improvement are key. They help in making sure that IMDs are diagnosed accurately. This is crucial for the health of newborns. The program showed that with the right tools and methods, labs can improve their performance. This is a big step forward in the fight against IMDs.