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I am interested in this topic from three angles: 1. What is your intent? To uncover analytic error or preanalytic error? 2. Do you fully investigate both the current (failed check) and the previous sample, or do you assume the previous sample result is accurate? 3. What is the positive predictive value of a failed check? How many failed checks do you investigate for every error found? In my lab, the time interval limit is set at 3d, and we delta check: Na (7 mmol/L change): for both analytic error or preanalytic error Cl (8 mmol/L change): for preanalytic error (IV fluid contamination) Total Protein (2g/dL change): for preanalytic error (IV fluid contamination or misidentified samples) Hemoglobin (40% change): for preanalytic error (IV fluid contamination or misidentified samples) MCV (5% change): for preanalytic error (misidentified samples) We investigate the current failed result fairly rigorously, and if no current error can found we may also investigate the previous sample, but allow the staff to make a judgment call regarding the current relevance of a possible correction of a previous result. We have not calculated the yield of the failed checks, but I would guess it is something like one error for every 20-50 failures investigated. We also use the delta check function for Troponin results, but this is mostly a means of automatically displaying the previous result (the range is set so tight that every Troponin will "fail" unless the exact same result is obtained). Gary Sandberg MT(ASCP) SC Technical Operations Manager PeaceHealth Laboratories Bellingham, WA USA [log in to unmask] www.peacehealthlabs.org -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammed El Sammak Sent: Saturday, June 04, 2011 6:30 AM To: [log in to unmask] Subject: Delta Check Dear Colleagues: I will be interested to know what other labs using to apply Delta Check (which analytes, cutoff values, time interval) Thanks Mohamed Dr Mohamed Elsammak Consultant Chemical Pathologist King Fahd Specialist Hospital Dammam Saudi Arabia Tel: 00966502952230 This message is intended solely for the use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential, and exempt from disclosure under applicable state and federal laws. If you are not the addressee, or are not authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the information contained herein. If you have received this message in error, immediately advise the sender by reply email and destroy this message. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/