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Related Experiment Video

Updated: Dec 31, 2025

The Visual Colorimetric Detection of Multi-nucleotide Polymorphisms on a Pneumatic Droplet Manipulation Platform

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Published on: September 27, 2016

Optimized Delta Check Rules for Detecting Misidentified Specimens in Children.

Rui Zhen Tan¹, Corey Markus², Kay Weng Choy³

¹Engineering Cluster, Singapore Institute of Technology, Singapore.

American Journal of Clinical Pathology

|January 1, 2020

Summary

Delta checks poorly detect misidentified pediatric samples. Optimized rules showed low accuracy, potentially causing false alarms and delayed results in pediatric laboratory testing.

Keywords:

Children Delta check Pediatric Preanalytical error Sample mix-up Wrong blood in tube

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Area of Science:

Clinical Chemistry
Laboratory Medicine
Pediatric Diagnostics

Background:

Preanalytical processes in pediatric care are often manual, increasing the risk of errors.
Accurate identification of pediatric patient samples is critical for reliable diagnostic testing.

Purpose of the Study:

To evaluate the effectiveness of optimized delta check rules for identifying mislabeled pediatric samples.
To determine the optimal delta check limits for pediatric laboratory tests.

Main Methods:

Assessed relative and absolute difference delta check limits on paired pediatric lab results.
Simulated sample mislabeling to test sensitivity, specificity, and accuracy.
Determined optimal delta check limits based on highest accuracy.

Main Results:

Delta check limits demonstrated poor to moderate accuracy (0.50-0.81) in detecting misidentified samples.
Sensitivity and specificity for identifying mislabeled samples were low across various delta check limits.
Both relative and absolute difference delta check rules performed similarly.

Conclusions:

Delta check methods exhibit poor performance in the pediatric population.
High false-positive rates can lead to unnecessary investigations and reporting delays.
Optimized pediatric delta checks correlate with biologic variation but not the index of individuality.