Development and Evaluation of "The Delta Plus-Minus Even Distribution Check": A Novel Patient-Based Real-Time Quality Control Method for Laboratory Tests.

BACKGROUND: Laboratory testing of large sample numbers necessitates high-volume rapid processing, and these test results require immediate validation and a high level of quality assurance. Therefore, real-time quality control including delta checking is an important issue. Delta checking is a process of identifying errors in individual patient results by reviewing differences from previous results of the same patient (Δ value). Under stable analytical conditions, Δ values are equally positively and negatively distributed. METHODS: The previous 20 Δ values from 3 tests (cholesterol, albumin, and urea nitrogen) were analyzed by calculating the R-value: "the positive Δ value ratio minus 0.5." This method of monitoring optimized R-values is referred to as the even-check method (ECM) and was compared with quality control (QC) testing in terms of error detection. RESULTS: Bias was observed on 4 of the 120 days for the 3 analytes measured. When QC detected errors, the ECM captured the same systematic errors and more rapidly. In contrast, the ECM did not generate an alarm for the one random error that occurred in QC. While QC did not detect any errors, the percentage of R-values exceeding the acceptable range was under 2%, the number of days generating alarms was between 16 and 21 days, with short alarm periods, and a median number of samples per alarm period between 7 and 9 samples. CONCLUSIONS: The ECM is a practical real-time QC method, controlled by setting R-value conditions, that quickly detects bias values.

[The Role of Clinical Laboratory Technicians at Bone Marrow Transplantation : Blood Test].

Transplantation therapy for hematopoietic diseases is conducted by a team led by an attending physician. After transplantation, various adverse effects occur, such as graft versus host disease (GVHD) and thrombotic microangiopathy (TMA), recurrence, and engraftment failure. Therefore, attending physicians are busy with the evaluation of laboratory data, monitoring of immunosuppressants, use of blood products, and management of infectious diseases. Under such circumstances, laboratory technicians play various roles. Our blood test technicians conduct tests to predict outcomes desired by attending physicians and report them quickly and accurately. For that purpose, they must develop skills to interpret test results and examine morphological findings. In this report, we introduce our efforts to improve post-transplantation medical care. [Review].