--- title: "Variability of quantitative viral PCR results: test samples. | Sutter Health" description: "The marked variability seen in clinical quantitative viral load results is associated with multiple aspects of molecular testing design and performance." url: "https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Variability of quantitative viral PCR results: test samples. # Factors contributing to variability of quantitative viral PCR results in proficiency testing samples: a multivariate analysis. Hayden RT, Yan X, Wick MT, Rodriguez AB, Xiong X, Ginocchio CC, Mitchell MJ, & Caliendo AM; College of American Pathologists Microbiology Resource Committee. _J Clin Microbiol. 50(2):337-45. doi: 10.1128/JCM.01287-11. Epub 2011 Nov 23._ 2012-02-01 ## Abstract While viral load testing has gained widespread acceptance, a primary limitation remains the variability of results, particularly between different laboratories. While some work has demonstrated the importance of standardized quantitative control material in reducing this variability, little has been done to explore other important factors in the molecular amplification process. Results of 185 laboratories enrolled in the College of American Pathologists (CAP) 2009 viral load proficiency testing (PT) survey (VLS) were examined. This included 165 labs (89.2%) testing for cytomegalovirus (CMV), 99 (53.5%) for Epstein-Barr virus (EBV), and 64 (34.6%) for BK virus (BKV). At the time of PT, laboratories were asked a series of questions to characterize their testing methods. The responses to these questions were correlated to mean viral load (MVL) and result variability (RV). Contribution of individual factors to RV was estimated through analysis of variance (ANOVA) modeling and the use of backward selection of factors to fit those models. Selection of the quantitative calibrator, commercially prepared primers and probes, and amplification target gene were found most prominently associated with changes in MVL or RV for one or more of the viruses studied. Commercially prepared primers and probes and amplification target gene made the largest contribution to overall variability. Factors contributing to MVL and RV differed among viruses, as did relative contribution of each factor to overall variability. The marked variability seen in clinical quantitative viral load results is associated with multiple aspects of molecular testing design and performance. The reduction of such variability will require a multifaceted approach to improve the accuracy, reliability, and clinical utility of these important tests. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/?term=hayden+rt%2C+yan+x) ![Xiaowei (Sherry) Yan, Ph.D.](https://dyn.mktgcdn.com/p/NTWox_hkmxIRiqJEc5PXKeBkfR_WMtpSQbEI4J69Xls/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Xiaowei (Sherry) Yan, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/xiaowei-sherry-yan-phd-1049681042) ## Research topics - [Infectious Disease](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Infectious+Disease%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Mycoplasma genitalium Incidence, Coinfection, and Antibiotic Resistance: A Prospective Study at a Walk-In Clinic in Los Angeles County, CA](https://www.sutterhealth.org/research/publications/mycoplasma-genitalium-incidence-antibiotic-resistance-1084355555) Open Forum Infection Diseases 2024 Aug 11 - Publication ### [Free latissimus dorsi flap used in treatment of cerebral aspergillosis: a case report and review of the literature.](https://www.sutterhealth.org/research/publications/latissimus-dorsi-flap-tx-cerebral-aspergillosis-1055312924) Antony AK, Hong RW, Amieva M, Taekman MS, Huhn SL, Karanas YL. 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Am J Manag Care. 11(7):426-32. 2005 Jul 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Variability of quantitative viral PCR results: test samples."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782#medicalscholarlyarticle","name":"Factors contributing to variability of quantitative viral PCR results in proficiency testing samples: a multivariate analysis.","headline":"Variability of quantitative viral PCR results: test samples.","abstract":"While viral load testing has gained widespread acceptance, a primary limitation remains the variability of results, particularly between different laboratories. While some work has demonstrated the importance of standardized quantitative control material in reducing this variability, little has been done to explore other important factors in the molecular amplification process. Results of 185 laboratories enrolled in the College of American Pathologists (CAP) 2009 viral load proficiency testing (PT) survey (VLS) were examined. This included 165 labs (89.2%) testing for cytomegalovirus (CMV), 99 (53.5%) for Epstein-Barr virus (EBV), and 64 (34.6%) for BK virus (BKV). At the time of PT, laboratories were asked a series of questions to characterize their testing methods. The responses to these questions were correlated to mean viral load (MVL) and result variability (RV). Contribution of individual factors to RV was estimated through analysis of variance (ANOVA) modeling and the use of backward selection of factors to fit those models. Selection of the quantitative calibrator, commercially prepared primers and probes, and amplification target gene were found most prominently associated with changes in MVL or RV for one or more of the viruses studied. Commercially prepared primers and probes and amplification target gene made the largest contribution to overall variability. Factors contributing to MVL and RV differed among viruses, as did relative contribution of each factor to overall variability. The marked variability seen in clinical quantitative viral load results is associated with multiple aspects of molecular testing design and performance. The reduction of such variability will require a multifaceted approach to improve the accuracy, reliability, and clinical utility of these important tests.","description":"The marked variability seen in clinical quantitative viral load results is associated with multiple aspects of molecular testing design and performance.","keywords":["Infectious Disease"],"datePublished":"2012-02-01","url":"https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"DOI","value":"10.1128/JCM.01287-11"}],"sameAs":["https://doi.org/10.1128/JCM.01287-11"],"isPartOf":{"@type":"Periodical","name":"J Clin Microbiol"},"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Infectious Disease","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Infectious+Disease%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/variability-of-quantitative-viral-pcr-results-test-samples-1055312782#breadcrumblist"}}} ```