Addressing Current Measurement Challenges with the Health 

Assessment Measurements Quality Assurance Program (HAMQAP)

Third Party Laboratories (34 %)

• Conduct independent sample testing for a fee

• Must demonstrate quality of their work

Industry Laboratories (32 %)

• Conduct testing of samples produced or collected

• Must demonstrate adequate quality control

Government Laboratories (19 %)

• Enforce regulations and evaluate product quality

• Must have an established reference for comparison

Academic Laboratories (10 %)

• Develop new methods and perform research

• Must have benchmark to evaluate new findings

Non-Profit R&D Centers (4 %)

• Develop new methods and perform research

• Must have benchmark to evaluate new findings

Standards Manufacturers (1 %)

• Develop calibration materials

• Must demonstrate utility of their products

HAMQAP Participants

All laboratories participate on a voluntary basis and without compensation. 

HAMQAP Background

In 2017, the National Institute of Standards and Technology (NIST) established the Health Assessment Measurements

Quality Assurance Program (HAMQAP) to identify, understand, and address community-wide measurement challenges.

This program helps to improve measurement accuracy by providing an opportunity for laboratories to assess their inhouse measurement performance and to demonstrate an effort to comply with applicable regulations. Standardization

programs, proficiency testing, interlaboratory comparisons, and participation in quality assessment programs (QAPs), in

conjunction with the use of reference materials (RMs), are all essential in order to improve the comparability and

precision of data over time.

NIST has extensive experience in the coordination of QAPs1 and the HAMQAP represents ongoing efforts previously

supported via historical QA programs, such as the Dietary Supplements Laboratory QAP, Micronutrients Measurement

QAP, Fatty Acids in Human Serum and Plasma QAP, and Vitamin D Metabolites QAP. HAMQAP exercises are focused on

health assessment as a whole by providing a variety of sample matrices for both human dietary intake (e.g., foods,

dietary supplements, and natural products) and human metabolism (e.g., urine, blood, serum, plasma, and human milk).

HAMQAP participants receive information regarding the accuracy and precision of their results, as well as concordance

within the community. Detailed study reports and certificates of completion are provided for participants, and

workshops and webinars are held to discuss results as well as methodological advancements in the area of health

assessment measurements.

Once the overall measurement performance within a community has been explored, accuracy and precision can be

improved through use of reference materials. Reference materials can be used to validate methods, establish

traceability, provide quality control when producing in-house reference materials, or produce scientific data that can be

referred readily to a common base. HAMQAP, in conjunction with the NIST Standard Reference Materials (SRM)

Program, supports development of well-characterized SRMs that are value assigned for chemical composition, by

incorporation of candidate reference materials into HAMQAP studies while using existing RMs and SRMs for quality

control. In collaboration with the National Institutes of Health Office of Dietary Supplements (NIH-ODS), NIST has

produced numerous reference materials for chemical composition of foods, dietary supplements, and clinical samples,

as well as botanical authenticity, by incorporating these materials into QAPs.

For more information about the HAMQAP, visit http://qa.nist.gov/hamqap, or email us at HAMQAP@nist.gov. 

HAMQAP Goals

The best way to know if a test is performing as expected is to utilize quality control materials (materials with known

characteristics or quantities) throughout the testing process. In the absence of quality control materials, another

approach is to participate in a proficiency testing or quality assurance program in which test results are compared to the

results from other laboratories, and ideally to a known value (determined independently or through participant

consensus). With participation, laboratories with outlying test results can improve performance by modifying protocols

or changing the testing procedure altogether.

The goal of the HAMQAP is to assist laboratories in identifying those tests that give incorrect or inconsistent results

and working with laboratories to improve their testing capabilities.

Dietary Intake Human Metabolites

Nutritional 

Elements

Iron

Multivitamin, Cereal

Iron, Transferrins

Human Serum

Toxic

Elements

Arsenic, Arsenic Species

Tobacco

†

, Kelp

Arsenic, Arsenic Species

Human Urine

Water-Soluble 

Vitamins

Vitamin B12

Multivitamin, Cereal

Vitamin B12

Human Serum

Fat-Soluble 

Vitamins

Vitamin D, Vitamin D Metabolites

Liver, Cod Liver Oil

Vitamin D, Vitamin D Metabolites

Human Serum

Fatty Acids

Fatty Acids

Solution, Fish Oil, Cod Liver Oil

Fatty Acids

Solution, Human Plasma

Natural Products

Actein, 27-Deoxyactein

Black Cohosh Rhizome, Leaves, Extract

Not offered

Contaminants

Mycotoxins

Corn

VOC Metabolites*

Human Urine

HAMQAP Exercise 1 Design

Vitamin D and Metabolites: Community Comparison

Cod Liver Oil

Consensus: 

3.29 mg/kg vitamin D3

22 % RSDR

Laboratories perform well for vitamin D 

in fortified foods and supplements. 

Few laboratories reported results for 

vitamin D metabolites in intake samples, 

but more participation is expected as 

requirements for vitamin D declaration 

on food labels change.

Fatty Acids: Community Comparison

HAMQAP Exercise 1: Lessons Learned

Charles A. Barber, Bruce A. Benner, Jr., Jeanice M. Brown Thomas, Carolyn Q. Burdette, Johanna Camara, Katrice A. Lippa, 

Stephen E. Long, Jacolin A. Murray, Melissa M. Phillips, Benjamin J. Place, 

Catherine A. Rimmer, Michael R. Winchester, Laura J. Wood, Lee L. Yu

National Institute of Standards & Technology, Gaithersburg, MD, USA

Human Serum

NIST Value: 40.1 ng/mL total 25OHD

Consensus: 40.1 ng/mL total 25OHD

6 % RSDR

Laboratories perform well in the 

determination of 25OHD in serum, as 

expected given the existence of numerous 

interlaboratory programs and reference 

materials with values assigned for 

vitamin D metabolites in human serum.

1Sander, LC et al.; Anal Bioanal Chem.; 2013 May; 405(13):4437-41. doi: 10.1007/s00216-013-6864-7.

† Study on tobacco was not funded by the NIH-ODS

* Cancelled due to low enrollment

• Improve measurement accuracy, precision, 

and comparability

• Identify measurement challenges and encourage 

discussions to improve analytical methods

• Encourage use of sound measurement practices, 

including the use of and need for RMs

NIST &

NIH-ODS

• Improve measurement processes

• Demonstrate accuracy and comparable 

performance to other laboratories

• Participate in complementary studies in 

dietary intake and human metabolism 

Participants

Fatty Acids Solution

NIST Value: 0.282 mg/g Total ARA

Consensus: 0.262 mg/g Total ARA

76 % RSDR

Food and supplement laboratories had 

difficulty measuring fatty acids at low levels 

in a solution. Laboratories must extend the 

linear range of their analytical method when 

the concentration in a sample is different 

than expected.

Fatty Acids Solution

NIST Value: 806 μmol/L Total ARA

Consensus: 761 μmol/L Total ARA

29 % RSDR

Clinical laboratories perform well in the 

determination of low levels of fatty acids, as 

would be expected in human serum samples. 

Sample preparation steps for fatty acids in 

serum are simpler than those for foods and 

supplements, which may also reduce withinand between-laboratory variability. 

Reference Materials

Reference Methods

Harmonization

Standardization

References Acknowledgements

Generous funding by the National Institutes of Health Office of Dietary Supplements (NIH-ODS), Analytical Methods and

Reference Materials Program is graciously acknowledged. The technical guidance of Dr. Adam Kuszak, Dr. Joseph Betz,

and Dr. Stephen Wise of NIH-ODS is also graciously acknowledged.