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A novel weighted cumulative delta-check method for highly sensitive detection of specimen mix-up in the clinical laboratory

  • Teppei Yamashita , Kiyoshi Ichihara EMAIL logo and Ayaho Miyamoto
Published/Copyright: February 6, 2013
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 51 Issue 4

Abstract

Background: We sought to detect specimen mix-up by developing a new cumulative delta-check method applicable to a mixture of test items with heterogeneous units and distribution patterns.

Methods: The distributions of all test results were successfully made Gaussian using power transformation. Values were then standardized into z-score (zx) based on reference interval (RI) so that limits of RI take zx=±1.96. To find a weight for summing absolute value of delta between current and previous zx (Dz), we evaluated the distribution of Dz. Its central portion was always regarded as Gaussian despite the presence of symmetrical long tails. Thus, an adjusted SD (aSD) representing the center was estimated with an iterative method. By setting 1/aSD2 as a weight factor, we computed a weighted mean of Dz as an index for specimen mix-up (wCDI).

Results: The performance of wCDI was evaluated, using a model laboratory database consisting of 32 basic test items, by a simulation study generating artificial cases of mix-up. When wCDI was computed from three commonly ordered test sets consisting of 6–9 items each, its diagnostic efficiency in detecting the artificial cases was 0.937–0.967 expressed as area under ROC curves (AUC). When the performance of wCDI was evaluated simply by the number of test items (p) included in the computation, AUC gradually increased from 0.944 (p=5) to 0.976 (p=8). However, when p≥10, AUC stayed at approximately 0.98.

Conclusions: wCDI was proven to be highly effective in uncovering cases of specimen mix-up. The diagnostic efficiency of wCDI depends only on the number of test items included in the computation.

Keywords: data-mining; delta-check method; laboratory information system; modified Box-Cox power transformation; quality management; within-individual differences
Corresponding author: Kiyoshi Ichihara, MD, PhD, Faculty of Health Sciences, Department of Clinical Laboratory Sciences, Yamaguchi University Graduate School of Medicine, Minami-Kogushi 1-1-1, Ube, 755-8505 Japan, Phone: +81 836 222884, Fax: +81 836 355213

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Received: 2012-11-04
Accepted: 2013-01-08
Published Online: 2013-02-06
Published in Print: 2013-04-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm-2012-0752
Keywords for this article
data-mining; delta-check method; laboratory information system; modified Box-Cox power transformation; quality management; within-individual differences

Articles in the same Issue

  1. Letters to the Editor
  2. Missing agreement between the two IMMULITE® PSA assays
  3. “Cerebrovascular stressing”: dipyridamole-induced S100B elevation predicts ischemic cerebrovascular events
  4. Discrepancy in lamellar body counts (LBCs) between the Sysmex XE-2100 and Sysmex XT-2000i instruments
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  7. The impact on costs and efficiency of reducing the number of collected tubes
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  9. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 are significantly related to PAPP-A levels
  10. Preliminary evaluation of complete blood cell count on Mindray BC-6800
  11. Rational use of laboratory tests: albuminuria
  12. Masthead
  13. Masthead
  14. Editorials
  15. Fifty years of CCLM – invitation to join us for a reception in Milan
  16. Personalized (laboratory) medicine: a bridge to the future
  17. PSA, PCA3 and the phi losophy of prostate cancer management
  18. Reviews
  19. Gender medicine: a task for the third millennium
  20. Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis
  21. Harmonization in laboratory medicine: the complete picture
  22. Opinion Papers
  23. Glycemic control in the clinical management of diabetic patients
  24. Time for a conceptual shift in assessment of internal quality control for whole blood or cell-based testing systems? An evaluation using platelet function and the PFA-100 as a case example
  25. Guidelines and Recommendations
  26. A position paper of the EFLM Committee on Education and Training and Working Group on Distance Education Programmes/E-Learning: developing an e-learning platform for the education of stakeholders in laboratory medicine
  27. General Clinical Chemistry and Laboratory Medicine
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