Usefulness of biological variation in the establishment of delta check limits

Biological variation is used in the calculation of reference change values (RCVs) for a delta check. In this study, we examined the correlation between intra-individual biological coefficients of variation (CVI) and delta check limits according to population distribution. A total of 1,533,359 paired...

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Bibliographic Details
Published in:Clinica chimica acta 2016-12, Vol.463, p.18-21
Main Authors: Lee, Jehoon, Kim, Soo-Young, Kwon, Hi Jeong, Lee, Hae Kyung, Kim, Yonggoo, Kim, Yeongsic
Format: Article
Language:English
Subjects:
Alanine Transaminase - analysis
Alanine Transaminase - metabolism
Albumins - analysis
Aspartate Aminotransferases - analysis
Aspartate Aminotransferases - metabolism
Biological variation
Chlorides - analysis
Clinical Chemistry Tests
Creatinine - analysis
Delta check
Delta check limit
Glucose - analysis
Humans
Population distribution
Potassium - analysis
Reference change values
Reference Values
Sodium - analysis
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Summary:Biological variation is used in the calculation of reference change values (RCVs) for a delta check. In this study, we examined the correlation between intra-individual biological coefficients of variation (CVI) and delta check limits according to population distribution. A total of 1,533,359 paired test results of nine routine chemistry tests were used to make the population distributions of delta percent changes. Their 0.5th, 2.5th, 97.5th, and 99.5th percentiles were then used for delta check limits. A large difference was observed between the chemistry tests in the percentage exceeding the delta check limits according to the RCVs. The mean percentage of test results of each test item exceeding the delta check limits of RCV95% ranged from 12.3% to 40.6%. Delta percent changes of protein, albumin, sodium (Na), potassium (K) and chloride (Cl) showed a symmetric distribution. However, an asymmetric distribution was observed in the delta percent changes of glucose, aspartate transaminase (AST), alanine aminotransferase (ALT) and creatinine. A good correlation was observed between CVI and the delta check limits according to population distribution and a closer correlation was observed when using the test items with CVI of
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cca.2016.08.007