Do Westgard rules need a modern revision for standardized and highly automated analytical systems?

The future of internal quality control (IQC) is unlikely to lie in replacing Westgard principles with a single new methodology. Rather, it may lie in determining how established statistical QC procedures can be integrated with risk-based planning, PBRTQC, analyzer diagnostics and longitudinal performance information. Artificial intelligence could eventually provide an additional integrative layer for this purpose, but its clinical utility must first be demonstrated through transparent validation and prospective evaluation. Thus, the modernization of IQC should be understood not as abandoning established statistical principles, but as testing and refining their implementation within an increasingly integrated, risk-based and data-rich laboratory environment. We believe that the future of IQC may not essentially lie in abandoning Westgard principles, but in integrating them within a broader, data-driven and risk-based quality framework.