Related Experiment Video
Updated: Dec 31, 2025
The Visual Colorimetric Detection of Multi-nucleotide Polymorphisms on a Pneumatic Droplet Manipulation Platform
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.
Insights
Delta checks poorly detect misidentified pediatric samples. Optimized rules showed low accuracy, potentially causing false alarms and delayed results in pediatric laboratory testing.
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.
Objectives:
Preanalytical processes in pediatric patients are generally manual and associated with a higher risk of error. The optimized delta check rules for detecting misidentified children samples are examined.
Methods:
Relative difference and absolute different delta check limits were applied on original and reshuffled (to simulate sample mislabeling/mix-up) paired deidentified pediatric results of 57 laboratory tests. The sensitivity, specificity, and accuracy of a range of delta check limits were determined. The delta check limit associated with the highest accuracy was considered optimal.
Results:
In general, the delta check limits had poor to moderate accuracy (0.50-0.81) in detecting misidentified patient samples. The sensitivity (rule out misidentified sample) quickly deteriorated at increasing delta check limits. At the same time, the specificity (rule in misidentified sample) of the delta check limit was also low. The performance of the relative difference and absolute difference delta check rules was similar.
Conclusions:
Our findings showed poor delta check performance in the pediatric population. The high false-positive flag rate may lead to wasteful resource-intensive investigations and delay in result reporting. In addition, we observed that the optimized pediatric delta check correlated strongly with within-subject biologic variation, whereas delta check accuracy correlated poorly with index of individuality.
More Related Videos
09:07Author Spotlight: Accelerating Diagnostic Accuracy with Direct Identification of Gram-Negatives from Blood Culture Bottles
Published on: May 24, 2024
08:23Single Droplet Digital Polymerase Chain Reaction for Comprehensive and Simultaneous Detection of Mutations in Hotspot Regions
Published on: September 25, 2018
Related Concept Videos
01:26Differential Staining Technique
01:00Detection of Gross Error: The Q Test