Is the combination of trueness and precision in one expression meaningful? On the use of total error and uncertainty in clinical chemistry.

The performance of all measurement procedures used in routine clinical laboratories shall be verified; a minimum is to verify the precision and trueness of the results. This is well established and adequate recommendations and procedures are available. Conveying this information in a form that is adequate and understandable for the practical end-user in the health care sector is still a much debated issue. By tradition, since several decades, the "total error" (TE) is presented, a quantity that is the linear sum of an imprecision and bias. Since any combination of the two can yield the same TE it may not be very helpful in finding and correcting a root-cause for an unacceptable value. Also, an acceptable TE may hide an unacceptable level of its constituents. An alternative is the measurement uncertainty (MU), which is recommended by accreditation and standardizing bodies The MU separates the imprecision and bias and expresses an interval around a best estimate within which the true value is expected with a certain probability. We describe the reporting the best estimate of a measurement result and describe how the uncertainty of the result, can be calculated, using simple custom-made software.