Delta checks

Tze Ping Loh; Rui Zhen Tan; Sunil Kumar Sethi; Chun Yee Lim; Corey Markus

doi:10.1016/bs.acc.2023.03.005

Delta checks

Adv Clin Chem. 2023:115:175-203. doi: 10.1016/bs.acc.2023.03.005. Epub 2023 Apr 1.

Authors

Tze Ping Loh¹, Rui Zhen Tan², Sunil Kumar Sethi³, Chun Yee Lim², Corey Markus⁴

Affiliations

¹ Department of Laboratory Medicine, National University Hospital, Singapore. Electronic address: tploh@hotmail.com.
² Engineering Cluster, Singapore Institute of Technology, Singapore.
³ Department of Laboratory Medicine, National University Hospital, Singapore.
⁴ Flinders University International Centre for Point-of-Care Testing, College of Medicine & Public Health, Flinders University, Adelaide, SA, Australia.

PMID: 37673520
DOI: 10.1016/bs.acc.2023.03.005

Abstract

Delta check is an electronic error detection tool. It compares the difference in sequential results within a patient against a predefined limit, and when exceeded, the delta check rule is considered triggered. The patient results should be withheld for review and troubleshooting before releasing to the clinical team for patient management. Delta check was initially developed as a tool to detect wrong-blood-in-tube (sample misidentification) errors. It is now applied to detect errors more broadly within the total testing process. Recent advancements in the theoretical understanding of delta check has allowed for more precise application of this tool to achieve the desired clinical performance and operational set up. In this Chapter, we review the different pre-implementation considerations, the foundation concepts of delta check, the process of setting up key delta check parameters, performance verification and troubleshooting of a delta check flag.

Keywords: Analytical error; Autoverification; Delta check; Laboratory error; Post-analytical error; Preanalytical error; Sample mix-up; Wrong blood in tube.