The Delta Check in Action: Causes and Consequences of Discrepant Laboratory Results
Discrepant results are often identified by delta check alerts. Delta checks compare current laboratory results to previous results; if the difference between the two values exceeds predetermined biological limits (within a predetermined length of time), a technologist is alerted and the discrepancy can be investigated further. Causes of discrepant laboratory results include both preanalytical and analytical issues, as well as true biological changes occurring within the patient.
Many preanalytical issues cannot be detected by traditional QC methods, leading to the possible reporting of erroneous laboratory results. The wrong result compromises patient care by leading to inappropriate diagnoses or treatment. Delta check alerts provide an additional means to identify these types of problems, in addition to alerting health care providers to true changes in their patient’s condition.
Originally presented on February 12, 2015 in Salt Lake City, Utah.
Joely A. Straseski, PhD, MS, MT(ASCP), DABCC
Medical Director, Endocrinology Laboratory, ARUP Laboratories
Assistant Professor of Pathology, University of Utah School of Medicine
Dr. Straseski is a medical director of endocrinology at ARUP and an assistant professor of pathology at the University of Utah School of Medicine. She received her PhD in pathology and laboratory medicine and a master of science in bacteriology from the University of Wisconsin-Madison, where she also served as a postdoctoral associate in the Department of Pathology. Dr. Straseski completed a postdoctoral fellowship in clinical chemistry at the Johns Hopkins Medical Institutions in Baltimore, Maryland. She has previously been awarded the Past-Presidents’ Scholarship by the American Association for Clinical Chemistry, as well as a Distinguished Abstract Award from the National Academy of Clinical Biochemistry. Dr. Straseski is board certified in clinical chemistry by the American Board of Clinical Chemistry.
After this presentation, participants will be able to:
- Define a delta check error or limit.
- Recognize sources of pre-analytical, analytical, and biological variation and how they may affect laboratory tests.
- Perform calculations that may be used to determine delta check limits.
- Outline important questions to ask when investigating a discrepant laboratory result.
University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories