A clinical evaluation of various delta check methods.

To evaluate the performance of delta check techniques, we analyzed 707 unselected pairs of continuous-flow test results, using three different delta check methods. If any of the test results (plus the urea nitrogen/creatinine ratio and the anion gap) failed one of the checks, the reason for the failure was sought by examining subsequent test results, retesting specimens, and (or) reviewing te patient's chart. Each delta check failure was accordingly classified as a true or false positive. The percentage of positives we judged to be true positives ranged from 5 to 29%. Each of the three methods had test types with low and high percentages of true positives. We conclude that with the delta check methods one can detect errors otherwise overlooked, but at the cost of investigating many false positives, because, in the population we studied, disease processes or therapy often caused large changes in a series of test results for a patient.