Clinical Chemistry
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Clinical Chemistry 21: 1648-1653, 1975;
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Clinical Chemistry, Vol 21, 1648-1653, Copyright © 1975 by the American Association for Clinical Chemistry

Patients as Their Own Controls: Use of the Computer to Identify "Laboratory Error"

Jack H. Ladenson 1

1 The Division of Laboratory Medicine, Departments of Pathology and Medicine, Washington University School of Medicine and Barnes Hospital, St. Louis, Mo. 63110

I describe a system of quality control based on computer detection of changes in individual patient test results. This system, called "delta check," was used to follow all the tests performed by the clinical chemistry laboratory in a 1200-bed hospital. Analysis of 22 months’ experience indicates that specimen misidentification is a serious problem in the clinical chemistry laboratory. Over a nine-month period, errors were most frequent in the results for total thyroxine, total calcium, and total protein. Instances of laboratory error detectable by the delta check system are not detected by other currently used methods of quality control. This system therefore appears to be a valuable asset to the clinical laboratory


Key Words: quality control • non-analytical sources of errors, and their frequencies • "delta check" system

Submitted on June 23, 1975
Accepted on July 29, 1975




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Copyright © 1975 by the American Association for Clinical Chemistry.