From Julia Nailling: What delta checks do laboratories commonly use for autoverification of prothrombin time with international normalized ratio (PT/INR), partial thromboplastin time (PTT), fibrinogen, and D-dimer?
Hi, Julia, thank you for your question. I’ll let our participants respond to this, as our own laboratory doesn’t use autoverification or delta checks, although we do carefully inspect results before they are released. The anecdotal answer I’ve heard is a 10% change, similar to my speculative answer to the previous question about reference ranges, but the limits may be adjusted for each parameter based on clinical significance. I also received this response from Chris Ferrell, University of Washington, “Sorry George, We don’t have a specific rule. It’s totally up to the director to decide.”
Julia, this is an opportunity for a new Quick Question, stay tuned!
Agree with comments made above.
We previously investigated
Agree with comments made above.
We previously investigated the use of delta ranges (INR) and used crticial difference calculation (Harris et al – uses Biological and analytical variation). Local findings agreed with publications – for actual variations of warfarin patients, with critical change 30% + for higher target INR. Hence I believe ‘global’ use of delta checks adds no value, we only repeat high values (After sample quality checks) or inconsistent results (If we get clinical details!).
We follow the same protocol as Joe Lamb. Delta checks would
We follow the same protocol as Joe Lamb. Delta checks would be nightmare in our coag population.
We don’t use delta check rules at all for coag auto release.
We don’t use delta check rules at all for coag auto release. We auto release coag unless it’s a critical value. You’ll be on the phones all day following up on your delta failures.
Hi George,
Interestingly, CLSI is going to develop an autov
Hi George,
Interestingly, CLSI is going to develop an autoverification document and currently it is seeking for volunteers.
Title: Autoverification of Clinical Laboratory Results for X (X represents each discipline that the guideline will address.)
-Ali