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Delta check limits for thyroid function tests adjusted for clinical settings.

Sunghwan Shin1, Shinae Yu2, Eun-Jung Cho3

  • 1Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|July 5, 2024
PubMed
Summary
This summary is machine-generated.

This study established practical delta check limits (DCLs) for thyroid function tests (TFTs) to prevent errors. Tailored DCLs are crucial, especially noting lower limits for health screening compared to other clinical settings.

Keywords:
Delta checkFree T4Thyroid hormonesThyroid-stimulating hormoneTotal T3

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Quality Assurance

Background:

  • Accurate thyroid function tests (TFTs) are vital for patient diagnosis and management.
  • Sample misidentification is a significant concern in laboratory testing, potentially leading to incorrect clinical decisions.
  • Establishing robust quality control measures, such as delta check limits (DCLs), is essential for ensuring the reliability of laboratory results.

Purpose of the Study:

  • To determine practical delta check limits (DCLs) for thyroid function tests (TFTs).
  • To assess the effectiveness of DCLs in detecting sample misidentifications across diverse clinical settings.
  • To identify potential differences in DCLs required for various healthcare environments, including health screening.

Main Methods:

  • Collected 610,437 paired TFT results from six university hospitals between 2020 and 2022.
  • Calculated absolute DCLs (absDCLs) using the 95th percentile from 60% of the data for each clinical setting.
  • Validated absDCLs using the remaining 40% of data and simulated mix-up datasets to determine sensitivity in detecting misidentifications.

Main Results:

  • Health screening settings demonstrated significantly lower absDCLs for TFTs compared to other clinical settings.
  • Specific differences were observed for thyroid-stimulating hormone, free thyroxine, and total triiodothyronine.
  • The sensitivity of absDCLs in detecting misidentifications varied significantly between health screening and other clinical settings.

Conclusions:

  • Practical DCLs for TFTs were successfully determined, offering a tool for error detection.
  • A notable disparity in absDCLs exists between health screening and other clinical settings, underscoring the need for tailored approaches.
  • Implementing setting-specific DCLs is crucial for enhancing the accuracy and reliability of TFT reporting.