Noklus Patient Median (NOPAM)

From June 1, 2024, Noklus will start the operation of NOPAM, a more user-friendly and improved version of the "percentile and flagger" program. Participants currently enrolled in the “percentile and flagger” program will be automatically transferred to NOPAM. From the same date, new participants can register.

For information in Norwegian, visit our Norwegian site.

What is NOPAM?

NOPAM is a program for internal and external quality assessment based on patient results, offered by Noklus to medical laboratories worldwide. Laboratories participating in the program regularly send a standardized report containing the patient median and percentage of patient results above and below the laboratory's own reference limits. The report also includes the number of results used to calculate the various parameters. Results are calculated per instrument. Preferably, data is calculated from patient results for the out-patient population. It is possible to participate only with patient medians. Upon initial registration and whenever changes occur, the following information is recorded; contact information for the laboratory, country, patient population, sample material, sampling conditions, methods, instrument information (supplier, model, and type) and factors for factorization of analytes. The reagent lot number can either be included in the results report or entered manually by the laboratory. If the lot number is registered manually, it is sufficient to register when the lot changes.

PowerPoint presentation about NOPAM

Analytes included in the program

How to use the results?

NOPAM can be a valuable tool to monitor analytical quality. The program can reveal important differences between different instrument types and methods, as well as monitor the progress of harmonization and standardization efforts. Participants can compare their own results with other comparable groups and compare different method groups. They can also compare their own results for all their own instruments, in case a bias is introduced, the laboratories monitor how the proportion of results above and below reference limits shifts. Results are presented in box plots or as a trend line with time on the x-axis. 

Monitoring of trends and warning routines

When participants log into NOPAM, analyte- and instrument-specific warnings are also seen in the event of a sudden change in the trend line, a bias for one instrument compared to previous results and for a difference between levels for one instrument compared to the entire instrument group. Setting appropriate warning limits for medians is challenging and a new feature in the program. In collaboration with participants and other experts in the field, NOKLUS will, work towards establishing suitable warning limits for use in NOPAM.

What do you have to do to participate in NOPAM?

Laboratories that wish to participate must contact us at Noklus, we will send a protocol describing how results are reported.

NOPAM support team:

Eva Rønneseth ( Program coordinator

Anne Elisabeth Solsvik ( Program manager