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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