Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta

Introduction: Delta check is a quality control tool that involves comparison of lab test result of current sample with that of previous sample from the same patient based on specified criteria. Though chemical analytes have been studied extensively for delta checking, literature is limited for haema...

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Main Authors: S Balamurugan, V Rohith
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2019-07-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/13027/41846_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdf
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author S Balamurugan
V Rohith
author_facet S Balamurugan
V Rohith
author_sort S Balamurugan
collection DOAJ
description Introduction: Delta check is a quality control tool that involves comparison of lab test result of current sample with that of previous sample from the same patient based on specified criteria. Though chemical analytes have been studied extensively for delta checking, literature is limited for haematology tests. Aim: In this ‘simulation’ study, we aimed to evaluate the performance characteristics of Complete Blood Count (CBC) tests in delta checking of specimen mix-ups/mis-identification using Receiver Operator Characteristics (ROC) analyses. Materials and Methods: Retrospective data from hospital patients (aged >18 years) for whom CBC tests were done within 14 days of primary testing were collected. Two groups were created: actual delta and simulated pseudo delta, the latter group simulating the real-time misidentified or mislabeled specimens. Performance characteristics of CBC analytes in detecting specimen mix-ups were evaluated by ROC curves and Areas Under Curves (AUC) using MedCalc statistical software. Results: AUC values observed for CBC analytes were: MCV (0.90), MCH (0.87) and RDW (0.82), Haematocrit (0.76), Haemoglobin (0.75), RBC count (0.75), Platelet count (0.72), MCHC (0.61) and Total leucocyte count (0.64). Indices of individuality (II) for CBC analytes were: MCH (0.27) <MCV (0.29) <Haemoglobin (0.42) <Haematocrit (0.42) <Platelet count (0.42) <RBC count (0.51) <Total WBC count (0.54) <RDW (0.61) <MCHC (0.88). Conclusion: MCV and MCH are the most ideal CBC analytes for delta checking of specimen mix-ups/mis-identification as they have low indices of individuality/Reference change values (RCV) and high AUC values. Integration of delta check in the Lab Information System (LIS) is an effective quality practice that can monitor release of erroneous lab results.
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spelling doaj.art-dcba3c1f236d4b0c83627e9a80c49e392022-12-21T23:15:07ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2019-07-01137EC09EC1110.7860/JCDR/2019/41846.13027Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) DeltaS Balamurugan0V Rohith1Professor, Department of Pathology, Chettinad Academy of Research and Education, Kancheepuram, Tamil Nadu, India.Student, Department of Pathology, Chettinad Academy of Research and Education, Kancheepuram, Tamil Nadu, India.Introduction: Delta check is a quality control tool that involves comparison of lab test result of current sample with that of previous sample from the same patient based on specified criteria. Though chemical analytes have been studied extensively for delta checking, literature is limited for haematology tests. Aim: In this ‘simulation’ study, we aimed to evaluate the performance characteristics of Complete Blood Count (CBC) tests in delta checking of specimen mix-ups/mis-identification using Receiver Operator Characteristics (ROC) analyses. Materials and Methods: Retrospective data from hospital patients (aged >18 years) for whom CBC tests were done within 14 days of primary testing were collected. Two groups were created: actual delta and simulated pseudo delta, the latter group simulating the real-time misidentified or mislabeled specimens. Performance characteristics of CBC analytes in detecting specimen mix-ups were evaluated by ROC curves and Areas Under Curves (AUC) using MedCalc statistical software. Results: AUC values observed for CBC analytes were: MCV (0.90), MCH (0.87) and RDW (0.82), Haematocrit (0.76), Haemoglobin (0.75), RBC count (0.75), Platelet count (0.72), MCHC (0.61) and Total leucocyte count (0.64). Indices of individuality (II) for CBC analytes were: MCH (0.27) <MCV (0.29) <Haemoglobin (0.42) <Haematocrit (0.42) <Platelet count (0.42) <RBC count (0.51) <Total WBC count (0.54) <RDW (0.61) <MCHC (0.88). Conclusion: MCV and MCH are the most ideal CBC analytes for delta checking of specimen mix-ups/mis-identification as they have low indices of individuality/Reference change values (RCV) and high AUC values. Integration of delta check in the Lab Information System (LIS) is an effective quality practice that can monitor release of erroneous lab results.https://jcdr.net/articles/PDF/13027/41846_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdfareas under curvedelta checksmean corpuscular volumemean corpuscular haemoglobinspecimen misidentification
spellingShingle S Balamurugan
V Rohith
Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
Journal of Clinical and Diagnostic Research
areas under curve
delta checks
mean corpuscular volume
mean corpuscular haemoglobin
specimen misidentification
title Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
title_full Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
title_fullStr Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
title_full_unstemmed Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
title_short Receiver Operator Characteristics (ROC) Analyses of Complete Blood Count (CBC) Delta
title_sort receiver operator characteristics roc analyses of complete blood count cbc delta
topic areas under curve
delta checks
mean corpuscular volume
mean corpuscular haemoglobin
specimen misidentification
url https://jcdr.net/articles/PDF/13027/41846_CE[Ra1]_F(KM)_PF1(AG_SHU)_PN(SL).pdf
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