Lab Med Online.  2023 Oct;13(4):324-331. 10.47429/lmo.2023.13.4.324.

Survey on the Implementation of Delta Checks and Panic Values in Immunoassays in Korea

• Lee H
• Shin KH
• Kim S
• Yoo SJ
• Yu S

• KMID: 2552759
• DOI: http://doi.org/10.47429/lmo.2023.13.4.324

Abstract

Background
This study aimed to inquire about the implementation of delta checks and panic values for immunoassays in clinical laboratories through an online survey.
Methods
A questionnaire survey was conducted on laboratory medicine specialists working in laboratories that perform five tumor markers, including alpha-fetoprotein, cancer antigen 125, cancer antigen 19-9 (CA19-9), carcinoembryonic antigen, and prostate-specific antigen (PSA), and thyroid function tests, including triiodothyronine, free thyroxine (T4), and thyroid-stimulating hormone.
Results
A total of 87 institutions responded to the questionnaire, and 75 laboratories (86.2%) were performing all 8 tests. The delta check was most used in the PSA test (38.8%, 33/85) and less used in CA19-9 (34.1%, 28/82). The delta percent change (DPC) formula was the most commonly used (65.6–92.6%). The criteria of DPC varied from 4.5 to 200%, and the most common was 50%, followed by 20%. Approximately 50% of laboratories using DPC did not use time intervals, and some laboratories used time limits as 1, 3, 6, or 12 months. The panic checks were most performed in CA19-9 test (51.2%, 42/82) and less performed in free T4 (36.0%, 31/86). The criteria for the panic value were mainly established based on the in-house laboratory data or data provided by reagent companies.
Conclusions
Many laboratories do not apply delta or panic checks in immunoassays. Further research on the suitable delta check criteria and panic values for the assay and patient characteristics is needed.

Keyword

Immunoassay; Delta check; Survey; Tumor marker; Thyroid function test

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