Delta Checks in the clinical laboratory.

International standards and practice guidelines recommend the use of delta check alerts for laboratory test result interpretation and quality control. The value of contemporary applications of simple univariate delta checks determined as an absolute change, percentage change, or rate of change to re...

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Publicado en:Critical Reviews in Clinical Laboratory Sciences Vol. 56; no. 2; pp. 75 - 98
Autores principales: Randell, Edward W, Yenice, Sedef
Formato: algorithm equations & formulas review tables/charts Journal Article
Publicado: Taylor & Francis Ltd Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2019
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/10408363.2018.1540536
        135862729
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        atl: Delta Checks in the clinical laboratory.
      aug:
        au:
          Randell, Edward W
          Yenice, Sedef
        affil: Discipline of Laboratory Medicine, Memorial University
      sug:
        subj:
          Clinical Laboratories
          Quality Control (Technology)
          Specimen Handling
          Health Care Errors Prevention and Control
          Strategic Planning
          Clinical Laboratory Information Systems
          Kidney Failure, Acute Diagnosis
          Creatinine Blood
          Sodium Blood
          Chest Pain
          Troponin
          Biological Assay Methods
          False Negative Results
          False Positive Results
          Demyelinating Diseases Risk Factors
          Demyelinating Diseases Diagnosis
      ab: International standards and practice guidelines recommend the use of delta check alerts for laboratory test result interpretation and quality control. The value of contemporary applications of simple univariate delta checks determined as an absolute change, percentage change, or rate of change to recognize specimen misidentification or other laboratory errors has not received much study. This review addresses these three modes of calculation, but in line with the majority of published work, most attention is focused on the identification of specimen misidentification errors. Investigation of delta check alerts are time-consuming and the yield of identified errors is usually small compared to the number of delta check alerts; however, measured analytes with low indices of individuality frequently perform better. While multivariate approaches to delta checks suggest improved usefulness over simple univariate delta check strategies, some of these are complex and not easily applied in contemporary laboratory information systems and middleware. Nevertheless, a simple application of delta checks may hold value in identifying clinically significant changes in several clinical situations: for acute kidney injury using changes in serum creatinine, for risk of osmotic demyelination syndrome using rapid acute changes in serum sodium levels, or for early triage of chest pain patients using high sensitivity troponin assays. A careful and highly selective approach to identifying delta check analytes, calculation modes, and thresholds before putting them into practice is warranted; then follow-up with careful monitoring of performance and balancing true positives, false negatives, and false positives among delta check alerts is needed.
      pubtype: Academic Journal
      doctype:
        algorithm
        equations & formulas
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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