National survey on delta checks in clinical laboratories in China

Abstract

BackgroundThis study aimed to understand the status quo of delta checks in Chinese clinical laboratories through a nationwide online survey.MethodsThe survey was divided into two parts. The first part was a general situation survey in which clinical laboratories had to provide information about the laboratories, including delta checks used. In the second part, clinical laboratories were asked to record the delta check alerts generated in their laboratories from June 1st, 2019 to June 30th, 2019.ResultsThe most frequently used analytes in delta checks were potassium (K), glucose (Glu), creatinine (Cre) for clinical chemistry and hemoglobin (Hgb), platelet (PLT) count and white blood cell (WBC) count for clinical hematology. The median maximum time interval between specimens for all analytes was 5 days. The most commonly used delta check calculation modes in Chinese clinical laboratories were percentage change and absolute change. K and Hgb were the analytes most involved in clinical chemistry and clinical hematology delta check alerts. The most common causes of delta check alerts were that the patients had received treatment, which was followed by the change in the patient’s physiological state and interference from hemolysis, lipemia and icterus. The two most common outcomes of delta check alerts were ‘no problems found, standard report issued’ and ‘no problems found, report issued with comment’.ConclusionsThis study was the first nationwide survey of delta checks in China, the results of which help us to understand the current situation of delta checks in Chinese clinical laboratories.

Performance evaluation of delta checks for error control in a hematology laboratory

“…This is analogous to a report where approximately half of MCV delta checks were associated with interim transfusion 9 . Similar observations were made in other clinical laboratories demonstrating treatments (28%) like dialysis and blood transfusion and change in their physiological state (23.3%) as the predominant reasons for delta checks 7 …”

“…on two consecutive CBC samples of a patient within a 24‐hour period. Rationale of using MCV for delta check was the high individuality of MCV making it a suitable analyte to detect misidentified samples in delta check 7 . International Consensus Group for Hematology Review in 2005 also recommended using delta checks for MCV to identify mislabeled specimens and to confirm sample integrity 5 .…”

Effective and Practical Complete Blood Count Delta Check Method and Criteria for the Quality Control of Automated Hematology Analyzers

“…However, according to Schifman, et al [10], transfusion and the patients' physical condition and treatment are common causes of delta check criterion exceedance. In a study by He, et al [27], the most common causes of delta check alerts were changes in the patient's physiological status according to treatment and follow-up and interference from hemolysis, lipemia, or icterus. Therefore, a delta check can help identify disease progression based on patient status.…”

“…In a study by He, et al . [ 27 ], the most common causes of delta check alerts were changes in the patient’s physiological status according to treatment and follow-up and interference from hemolysis, lipemia, or icterus. Therefore, a delta check can help identify disease progression based on patient status.…”

The concurrence of the current postanalytical phase management with the national recommendations

“…, detection of specimen mix-up errors, contaminated specimen ( e.g. , IV fluid), and analytical error ( 17 , 18 ).…”