Advances for proficiency testing for genetic laboratory science

Nucleic acid based clinical genetic testing has undergone explosive growth in recent years due in large part to the human genome project. Characterization of the human genome has led to a molecular understanding of the pathogenesis of many human diseases, and ultimately to clinical molecular tests becoming routinely used to diagnose a wide diversity of diseases. This rapid growth in clinical molecular genetic testing coupled with the complexity of the analytical procedures underscores the necessity for proficiency testing (i.e. external quality assessment) to allow laboratories offering such services the ability to evaluate their analytical procedures via inter-laboratory comparisons. The American College of Medical Genetics (ACMG) in partnership with the College of American Pathologists (CAP) have been offering proficiency testing for clinical molecular genetics laboratories since 1995, and presently have more than 230 laboratories from 11 countries enrolled in this program. This paper describes the evolution of this program and several challenges encountered in the delivery of a proficiency testing program for laboratories offering clinical molecular genetic services.