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Application and optimization of reference change values for Delta Checks in clinical laboratory
Jinyoung Hong1, Eun-Jung Cho2, Hyun-Ki Kim3
1Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of Clinical Laboratory Analysis
|August 31, 2020
Summary
The Reference Change Value (RCV) method for delta checks shows higher error detection rates than conventional methods. However, modifications are needed to reduce workload in clinical laboratories.
Area of Science:
- Clinical Chemistry
- Laboratory Quality Control
Background:
- Delta check is a patient-based quality control tool comparing current and previous test results.
- Reference Change Value (RCV) is a guideline-recommended delta check method, but its performance requires verification.
Purpose of the Study:
- To apply and modify the RCV-based delta check method using patient data.
- To evaluate the performance of RCV-based delta check compared to conventional methods.
Main Methods:
- RCV was calculated using internal QC materials and biological variation data.
- Test results for 17 analytes from inpatients, outpatients, and health examination recipients were analyzed.
- Detection rates of RCV-based and conventional delta check methods were compared and modified.
Main Results:
- The RCV-based method demonstrated higher detection rates than the conventional method.
- Modifications, such as removing results within the reference interval, reduced detection rates.
- Adjusting RCV by time interval or using a modified cutoff value also impacted detection rates.
Conclusions:
- RCV is a robust criterion for delta checks and is included in clinical laboratory guidelines.
- The RCV-based method's high detection rates can increase laboratory workload.
- Modifications are necessary for effective clinical laboratory implementation of RCV-based delta checks.
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