2.6 Outcomes before and after real-time quality control
To determine whether performing real-time quality control influenced outcomes, we compared mean outcomes (LCI; FRC) and variability (coefficient of variation; (CV)) before and after implementing real-time quality control. Further, we assessed the impact on MBW outcomes of including D grade trials within 10% variability of good quality trials as proposed in this manuscript.

2.7 Data analysis

For this study, we examined MBW test acceptability before and after implementation of real-time quality control in the clinical setting. Before the implementation of real-time quality control, as primary outcome, we compared test acceptability reported in the clinical reports generated by MBW operators to those reported following retrospective quality control by the experienced reviewer (BF). After the implementation of real-time quality control, as primary outcome, we compared test acceptability and trial acceptability reported at the time of the measurement by MBW operators to those reported following retrospective quality control by the experienced reviewer (BF). As a secondary outcome, we assessed the agreement in test acceptability and trial grading between the MBW operator and an experienced reviewer. Agreement was assessed using kappa statistics. We also compared MBW outcomes (mean and within-test coefficient of variation for FRC and LCI) reported by the operator and reviewer using unpaired t-tests. All statistical analysis was performed using Stata 16.0 (StataCorp 2019)16.

3. Results