CIQAP (Canadian Immunology Quality Assessment Program)

CIQAP is the Public Health Agency of Canada’s domestic external quality assurance (EQA) program for CD4+ T cell enumeration, located at the National Laboratory for Sexually Transmitted and Bloodborne Infections in Winnipeg, Canada.  CD4+ T cell enumeration by flow cytometry remains an important indicator of a patient’s immune and clinical status, as well as a critical indicator of immune status at time of diagnosis to assess the risk for development of opportunistic infections.

CIQAP provides EQA through administration of proficiency testing (PT) panels and comprehensive corrective and preventative action as required in English and French. The primary objective of CIQAP is to ensure reproducible and accurate T-cell subset measurements by flow cytometry. 

Frequency of distribution: Three fresh whole blood specimens (1.5mL) are sent to each participating lab 3 times per year according to a pre-established shipping schedule. A notification is sent via email to each participant prior to the survey.  The laboratory confirms their participation via the CIQAP website.  Samples are sent by FedEx via either land or air transportation. All samples are to be processed as routine blood specimens for leukocyte phenotyping upon arrival, and must be handled according to laboratory biosafety guidelines. Each laboratory is required to report lymphocyte T-cell subset percentages of CD3+, CD3+CD4+ and CD3+CD8+.  Absolute count values can also be reported as whole numbers (cells/µL), but are not required. For single platform users, this is to be obtained using absolute count beads such as Flow-Count or TruCount. 

Data collection takes place through a web database platform, the CIQAP website (https://ciqap.canada.ca) and statistical results are provided in a performance report to each participant.

Corrective action is a critical component of  CIQAP.  Participants are contacted with requests for electronic files and a copy of their flow cytometry printouts for analysis when further investigation is required and guided in corrective actions needed for performance improvement.  Due to the interactive nature of the program, participants are encouraged to communicate any concerns to the quality improvement team.

The primary objective of CIQAP is to ensure reproducible and accurate T-cell subset measurements by flow cytometry.

There is no fee to enrol or participate in the CIQAP program. 

Eligible participants are those hospitals and laboratories actively performing testing for CD4+ T cell enumeration by conventional flow cytometry.

Confidentiality of testing results and performance is maintained using a password protected online database and numerical laboratory IDs to distinguish testing sites.  Summary data from each session is released to all participants, though the participant anonymity is maintained through the use of their specified laboratory IDs.  Participants will be notified via email prior to sending any results from past or present CIQAP sessions to regulatory authorities or interested parties.

Policy on collusion and/or falsification of data: The CIQAP program takes any accusation of collusion or falsification of data very seriously and has a zero tolerance policy.  Any report of this nature will be thoroughly investigated and if founded, participants can face suspension from the CIQAP program.

To apply to participate in the CIQAP program please contact ciqap@phac-aspc.gc.ca.

Appeals process: if any participant would like to appeal their results, they can email this request to ciqap@phac-aspc.gc.ca.