In East Kent, we took the approach of starting out with all AKI scores suppressed. NA and 0 are autovalidated, whilst 1,2, and 3 are sent to be manually desuppressed before validation.
It's not a brilliant system, to be honest, it's far too easy to accidentally validate out an AKI score without desuppressing it - we have a list set up to regularly check for missed scores. CSC have recently released an update allowing an AKI score to be highlighted, which will hopefully improve the situation. I was playing with the idea of a dummy/calculated test to get around all this but never had the patience to get it working - plus I really don't trust APEX's rule system.

Alan.

Dr Alan Dodd, Senior Clinical Scientist
Biochemistry, William Harvey Hospital
Ashford, Kent.

On Tue, 30 Jun 2015 14:48:41 +0000, Hayden Katharine (RW3) CMFT Manchester <[log in to unmask]> wrote:

>As another Apex user, rather than delay implementation of the AKI alerts, we went live and report AKI 0 and NA with the following comments.
>
>AKI Stage 0 No current indication of AKI
>AKI Stage NA Insufficient data to determine AKI Stage
>
>There is an additional issue that in the AKI algorithm for AKI NA alerts due to not having a previous result in the last 364 days, if the creatinine is raised then a comment as below is added, so this is also contrary to the best practice guidance of not reporting AKI NA.
>
>High Creatinine ?AKI ?CKD. Suggest repeat bloods
>
>Regards,
>Kath 
>
>Katharine Hayden FRCPath
>Consultant Clinical Biochemist & Head of Service
>Dept of Clinical Biochemistry
>Manchester Royal Infirmary
>Oxford Road, Manchester M13 9WL
>Tel: 0161 701 1106
>Fax: 0161 276 4586
>www.cmft.nhs.uk  Central Manchester University Hospitals NHS Foundation Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital, Royal Manchester Children's Hospital, Saint Mary's Hospital, University Dental Hospital of Manchester, Trafford Hospitals and Community Services.
>
>    
>
> 
>-----Original Message-----
>From: ACB AKI-Detection-Algorithm [mailto:[log in to unmask]] On Behalf Of Rob Goodison
>Sent: 30 June 2015 14:13
>To: [log in to unmask]
>Subject: iLAB (APEX) sites and AKI 'null' results.
>
>All iLAB (APEX) sites/users:
>
>As detailed in the 'AKI Warning Algorithm Best Practice Guidance' document, null results (AKI NA and AKI 0) should not be reported.
>
>The issue with iLAB is that a test can either be suppressed, or unsuppressed, but core functionality doesn't allow a test to be either, depending on result value.
>
>I'm working with CSC to test a routine that has the potential to suppress a result based on its value (i.e. If AKI EQ NA or AKI EQ 0 then suppress, else leave unsuppressed) - but there are some teething issues, and I do not want to compromise any potential go-live date here. We've experienced more than our fair share of delays due to inept decision making and issues with CSC's AKI module.
>
>What are other iLAB sites doing regarding these 'null' results?
>
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