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Abstract The quality, efficacy, and safety of medicines are usually verified by analytical results. Measurement uncertainty is a critical aspect for the reliability of these analytical results. The pharmacopeial compendia usually adopt a simple acceptance rule that does not consider information from measurement uncertainty. In this work, we compared decision-making using simple acceptance and decision rules with the use of guard-band for multiparameter evaluation of ofloxacin ophthalmic solution and acyclovir topical cream. Ciprofloxacin ophthalmic solution and acyclovir topical cream samples were subject to pharmacopeial tests and assays. Multivariate guard-band widths were calculated by multiplying the standard uncertainty (u) by an appropriate multivariate coverage factor (k'). The multivariate coverage factor (k') was obtained by the Monte Carlo method. According to the simple acceptance rule, all the results obtained for ciprofloxacin ophthalmic solution and acyclovir topical cream are within the specification limits. However, the risk of false conformity decisions increases for ciprofloxacin tests. Decisions made using the simple acceptance rule and decision rules with the use of guard-band may differ. The simple acceptance rule may increase the risk of false conformity decisions when the measured value is close to the regulatory specification limits and/or when the measurement uncertainty value is inappropriately high. Nevertheless, the guard-band decision rule will always reduce the risk of false conformity decisions. Therefore, using information on measurement uncertainty in conformity assessment is highly recommended to ensure the proper efficacy, safety, and quality of medicines.

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Abstract Medicines must be subject to physical, chemical, and biological analysis to guarantee their quality, safety, and effectiveness. Despite the efforts to ensure the reliability of analytical results, some uncertainty will always be associated with the measured value, which can lead to false decisions regarding conformity/non-conformity assessment. This work aims to calculate the specific risk of false decisions regarding conformity/non-conformity of acetaminophen oral solution dosage form. The acetaminophen samples from five different manufacturers (A, B, C, D, and E) were subject to an active pharmaceutical ingredient assay, density test, and dose per drop test according to the official compendia. Based on measured values and their respective uncertainties, the risk values were calculated using the Monte Carlo method implemented in an MS Excel spreadsheet. The results for two acetaminophen oral solution samples (C and D) provided an increased total risk value of false acceptance (33.1% and 9.6% for C and D, respectively). On the other hand, the results for the other three acetaminophen samples (A, B, and E) provided a negligible risk of false acceptance (0.004%, 0.025%, and 0.045% for A, B, and E, respectively). This indicates that measurement uncertainty is very relevant when a conformity assessment is carried out, and information on the risks of false decisions is essential to ensure proper decisions.

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Dissolution is used to determine the rate and extent of drug release from the dosage form into a dissolution medium, which allow to assess the batch-to-batch variability. Considering that the dissolution test is used to predict the vivo performance of the drug as well, it is important to guarantee the quality and reliability of dissolution test results. The aim of this work was to evaluate the measurement uncertainty arising from sampling and analytical steps of dissolution test of prednisone tablets. Dissolution test was performed using 900 mL of purified water as dissolution medium and a dissolution apparatus equipped with paddles rotating at 50 rpm for 30 min. Quantification was performed by UV spectrophotometer. Uncertainty arising from sampling was estimated using the duplicate method (empirical approach), using 17-sampling target, two samples for each sampling target, and three replicas for each sample, totalizing 102 analyses. Uncertainty arising from analytical steps considered the uncertainty from dissolution step (estimated using Monte Carlo method and regression equation obtained using DoE) and uncertainty from quantification step. Overall uncertainty value was found to be 2.2%, which is below the target uncertainty value (ut =2.5%). The contributions of uncertainty sources in this study were as follows: 24% from sampling uncertainty, 29% from the dissolution step uncertainty, and 47% from the quantification step uncertainty. The results of dissolution test should be compared to the specification limits (Q). According to the pharmacopeia requirements, the batch of the medicine should be declared compliant if the dissolved amount of prednisone for six tablets are above the specification limits + 5% (Q+5%=85%). Since the measured values for all six tablets (96.5%, 94.0%, 96,4%, 95.3%, 96.0%, and 96.9%) were above the multivariate acceptance limit (90.2%, calculate as the standard uncertainty multiplied by multivariate coverage factor), the batch of the prednisone tablets was declared complaint, with a reduced total risk of false decision (total risk value below 5%).

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Analytical results are often used in scientific research, industrial and clinical applications to support decision making. Despite all efforts to ensure the reliability of analytical results (including method validation, internal quality control, use of certified reference materials, proficiency tests, and ISO 17025 accreditation), there will always be an uncertainty associated with the measured value. The measurement uncertainty expresses the quality of the analytical result and allows the comparability between analytical results or between the measured value and the specification limit(s). This work discusses the importance of measurement uncertainty, including the steps involved in the measurement uncertainty evaluation, the bottom-up and top-down approaches used in measurement uncertainty calculation, the measurement uncertainty evaluation in drug and medicine analyses, and the application of measurement uncertainty in conformity assessment for quality control, stability studies, and pharmaceutical equivalence.

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The quality assessment of medicines involves multiple compliance parameters, such as identity, dosage, purity, potency, content uniformity, disintegration time, dissolution rate, among others. The measurement uncertainty associated with a measured value can affect the conformity assessment and, consequently, it impacts decision-making. Even if the particular risks are acceptable, the total risk may be significantly high. Thus, the aim of this work was to develop a procedure for the definition of acceptance (or rejection) limits applied to multiple compliance assessments, that ensure acceptable particular and total risks. The multiple compliance assessments were performed and applied in the pharmaceutical equivalence studies for cisplatin injectable solution, carboplatin injectable solution, ranitidine tablets, and acetaminophen oral solution from several manufacturers. Pharmaceutical equivalence studies were performed adopting pharmacopeial analytical procedures. All chromatographic system suitability results complied with the requirements regarding the resolution between peaks, the capacity factor, the tailing factor, the theoretical plates, and the relative standard deviation for replicate injections. Univariate and multivariate guard-bands (g and g', respectively) were calculated by multiplying the standard uncertainty (u) by an appropriate univariate and multivariate coverage factor (k and k', respectively).The values of multivariate guard band (g') were higher than the values of univariate guard bands (g), which leads to more restrictive acceptance intervals. Measured values between the conventional and the multivariate acceptance limits will ensure particular risk values below the maximum acceptable value, however, the total risk may be significantly high. On the other hand, measured values within the multivariate acceptance limits ensure that particular risk values and total risk value are below the maximum acceptable value The application of multivariate guard bands is a simple way to ensure reduced particular and total risks of false conformity decisions, which is of great interest to regulatory agencies and the manufactures of the medicines.

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Pharmaceutical products must meet quality requirements to ensure the efficacy and safety of pharmacological treatment. Non-compliance of medicines can cause economic losses and compromise the patient's health. In this work, the risks of false compliance/non-compliance decisions for parenteral antibiotics (cephalothin, ciprofloxacin and metronidazole) were evaluated on the basis of analytical results, measurement uncertainties and specification limits. Physicochemical and biological quality assays were performed according to pharmacopeial procedures. Measurement uncertainties were determined using the bottom-up approach or the probability of false-positive/false-negative results. The risks of false compliance/non-compliance decisions were estimated using the frequentist approach and Monte Carlo simulations. Guard-bands were determined through a validated spreadsheet for calculating univariate and multivariate acceptance limits. All risk values (particular risks and total risk, consumer's or producer's risk) were below the maximum permissible risk value. The univariate and multivariate guard-bands defined more restrictive specification values, reducing the risks of false compliance/non-compliance decisions. One antibiotic presented unsatisfactory results regarding the drug content and was classified as out of specification product. The application of risk management tools in the pharmaceutical area contributes to improving the quality and safety of products and supports decision-making.

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The pharmaceutical equivalence between test (generic or similar) and reference medicine is evaluated through in vitro quality tests involving multiple compliance parameters. Despite efforts to ensure the reliability of the analytical results obtained in the pharmaceutical equivalence studies, measurement uncertainties lead to a risk of false decisions. Thus, the aim of this work was to evaluate the measurement uncertainties associated with the analytical results obtained in the pharmaceutical equivalence studies of different pharmaceutical forms and to estimate the risks of false decisions in the evaluation of pharmaceutical equivalence. The measurement uncertainties associated with the test results were evaluated using the bottom-up and top-down approaches. The consumer's or producer's combined particular risks and combined total risks were estimated using the Monte Carlo method implemented in MS-Excel spreadsheet (available as supplemental material). Considering the seven pharmaceutical equivalence studies performed in this work, three studies were not conclusive (risk of false pharmaceutical equivalence decisions higher than 5 %). Moreover, we concluded pharmaceutical equivalence and pharmaceutical non-equivalence in one and three studies, respectively. The particular and total combined risks are useful to make decisions regarding the evaluation of pharmaceutical equivalence between the test (generic or similar) and reference medicines. Regulatory bodies and pharmaceutical equivalence centers are very interested in the estimation of the risks of false decisions, particularly to evaluate the quality of medicines that are not submitted to bioequivalence studies.

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The low-quality of automotive fuels may lead to the generation of pollutants harmful to both environmental and human health. The quality evaluation of automotive fuels requires a multiparameter conformity assessment, which may lead to an increased total risk of false conformity decisions even if all parameters comply with the acceptance limits. Thus, the aim of this work was to propose the establishment of multivariate acceptance limits in order to ensure a reduced total risk of false conformity decisions applied to automotive fuels analysis. Particular and total (consumers' and/or producers') risks were estimated using frequentist (specific) and Bayesian (global) approaches. Multivariate acceptance limits were estimated using Monte Carlo method, adopting an appropriate multivariate coverage factor (k') defined using MS Excel Solver function. The definition of multivariate acceptance limits ensures a total risk below the maximum admissible risk (typically 5%) and was successfully employed in the conformity assessment of automotive fuels (diesel and gasoline). The employment of the multivariate acceptance limits may be useful in the conformity assessment of several multiparameter products.

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The measurement uncertainty (MU) related to analytical results can lead to false decisions in conformity assessment, such as accepting or rejecting incorrectly a medicine lot (consumer's and producer's risks, respectively). These risks can be global or specific. It is important to understand the different types of conformity decision risks, and the different approaches to estimate them to ensure the reliability of the analytical results. Thus, the aim of this work was to estimate the specific consumer's and producer's risks from the MU values of 64 liquid chromatography analytical procedures for antibiotic or antifungal assays, in order to evaluate their performances in conformity assessment. The specific risks of the analytical procedures were estimated by the frequentist approach following normal distribution using Microsoft Excel® software, and in addition a spreadsheet was created to be available as supplementary material to estimate specific risks by this approach. Moreover, the global risks of the analytical procedures were estimated using Bayesian approach, assuming a uniform scenario of production process. And finally, the estimation of specific risks by Bayesian and frequentist approaches was compared. Only 39 % of the evaluated analytical procedures had MU within the recommended. When the result is close to the specification limit, the risk can be significant, in such cases, a strategy is to adopt guard bands to reduce or expand the specification limits, minimizing the risks. The spreadsheet created shows the risk of false decision for a MU value, considering results within and outside the specification limits, allowing to verify the risk according to the analytical result obtained. The global risks values were practically equal to the expanded uncertainty values, as there is no tendency of the production process between lots within or outside the specification, but once the analytical result is known, the frequentist approach provides a more reliable risk estimate (specific risk). The specific risks estimated by Bayesian and frequentist approaches were divergent by the influence of the production process information on the first approach, which may overestimate or underestimate the consumer's and producer's risks regarding the frequentist approach. Failures in medicine conformity assessment can cause much damage, therefore, preventive actions such as developing, evaluating and/or optimizing analytical procedures, are essential in order to guarantee measurement uncertainties below or equal to the target and adopt routine strategies to minimize the risk of false decisions in conformity assessment.

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Liquid chromatography is one of the main techniques used in pharmaceutical quality control analytical procedures. However, there will always be a measurement uncertainty (MU) associated with them, that can lead to the approval of an out of specification lot (consumer risk) or rejection of a lot within specification (producer risk). Thus, the aim of this study was to evaluate the performance of liquid chromatography analytical procedures based on their measurement uncertainty and to estimate the risk of false conformity decisions. The uncertainties of the analytical procedures were estimated based on the results of validation (trueness and precision). Then, the ratio between overall uncertainty and specification range (U/T%) was calculated. It was noted that in most cases (73%), random errors (precision) contributes more significantly to the overall uncertainty when compared to systematic errors (trueness). Monte Carlo method was used, generating different manufacturing processes scenarios, and analytical results based on the MU of each analytical procedure. Then, consumer's and producer's risks were estimated from the simulated values. Pharmaceutical dosage forms that require more steps in sample preparation had higher measurement uncertainties, often above the recommended target uncertainty. As most of the analytical procedures showed U/T% values above recommended, the majority presented high estimated risk values and did not fit for purpose. Therefore, it is important to considerate the measurement uncertainty as part of analytical procedures validation, since trueness and precision values affect directly the measurement uncertainty and the risk of false conformity decisions.

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A simple extraction, rapid routine method for the simultaneous determination of sorbic acid, natamycin and tylosin in Dulce de leche, a traditional South American product, by liquid chromatography-tandem mass spectrometry has been developed and fully validated. The limits of detection were set to 24.41mgkg(-1) (sorbic acid), 0.10mgkg(-1) (natamycin) and 2µgkg(-1) (tylosin). Recoveries ranged from 95% to 110%. Proportionally, internal standardization was more efficient than external standard, resulting in a smaller measurement of uncertainty. In total, 35 commercial samples from Brazil, Argentina and Uruguay have been assessed. The proposed method was tested on other dairy desserts, demonstrating to be versatile. Although tylosin was not detected in any sample, a high rate of non-compliance was found, with 67.39% of samples above the maximum allowed for sorbic acid and a maximum concentration of 2105.36±178.60mgkg(-1). In two samples, natamycin was irregularly found.

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In this work, a simplified extraction and short time of analysis method for the simultaneous determination of natamycin, nisin and sorbic acid in cheeses and cream by reverse phase liquid chromatography-electrospray-tandem mass spectrometry was developed. Full validation was performed according to the Commission Decision 2002/657/EC criteria and method applicability was checked on several samples, aiming to inspect their compliance with regulatory limits. The method was linear in the concentration ranges of 0-10mg kg(-1) (natamycin), 0-25mg kg(-1) (nisin) and 0 20mg kg(-1) (sorbic acid). Samples of the three most consumed types of cheese (fresh, pasta filata and ripened) in Brazil and cream (ultra high temperature and pasteurized, 20-30% fat content) were assessed. A surprising rate of non-compliance was observed, especially among ripened grated cheeses, since 80% of samples were above the maximum limit for sorbic acid with an average concentration of 2766.3±10.8mg kg(-1). Moreover, a major non-compliance for the cream samples was observed. The proposed method can be applied as an efficient tool for the inspection of preservatives in cheeses and cream.

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Com a expansão das Unidades Produtoras de Refeições, os alimentos ficaram mais expostos e sujeitos à contaminação microbiana devido às práticas incorretas de manipulação e processamento. Para o alimento se tornar fonte de saúde imprescindível ao ser humano, deve ser processado dentro de um controle de etapas, no qual a temperatura em que, alimento é mantido, tempo gasto durante seu preparo, utilização de matéria-prima de boa qualidade, condições higienicossanitárias satisfatórias, e sendo convenientemente armazenado e manipulado para obter- -se uma melhoria na qualidade e uma minimização dos riscos de surto de origem alimentar. O presente estudo objetivou avaliar as condições higienicossanitárias de duas unidades de uma rede de restaurantes comerciais localizadas em São Paulo, SP. Os resultados demonstraram que a UI propiciou maior inadequação quanto à higiene do ambiente e dos equipamentos e a U2 apresentou-se não conforme com maior frequência em relação aos alimentos e equipamentos. A aplicação do checklist permitiu concluir que foram detectadas várias falhas operacionais, quanto ao controle higienicossanitário, sendo necessários treinamentos e ações corretivas para abordagem da importância das boas práticas de fabricação, melhorando a qualidade higienicossanitária das unidades estudadas. (AU)

With the restaurant expansion foods were more exposed to microbial contamination due to incorrect practices of handling and processing. For food to become indispensable fountain of human health, must be processed within steps control, in which the food temperature maintenance, preparation time, good quality of materials, satisfactory hygienic- -sanitary, and being conveniently stored and manipulated to obtain an improvement in quality and minimal risks a minimization of food disease. This study aimed to evaluate the hygienic sanitary conditions in two units of a commercial restaurants network located in São Paulo, SP The results showed that the greatest inadequacy as U1 provided to environment and equipment hygiene and U2 performed most frequently not compliance food and equipment. The check list application that were detected several operational failures, how hygienic-sanitary control, training and corrective actions are necessary to approach the importance of good manufacturing practices, improving sanitary quality of the studied units. (AU)

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