Abstract：
BACKGROUND: This study aimed to determine practical delta check limits (DCLs) for thyroid function tests (TFTs) to detect sample misidentifications across various clinical settings.
METHODS: Between 2020 and 2022, 610,437 paired TFT results were collected from six university hospitals. The absolute DCL (absDCL) was determined using the 95th percentile for each clinical setting from a random 60 % of the total data. These absDCLs were then tested within and across different settings using the remaining 40 % of the data, alongside mix-up datasets for result and sample comparisons. The sensitivities of absDCL were calculated within and across groups in the mix-up datasets.
RESULTS: Health screening absDCLs were notably lower than in other settings (2.58 vs. 5.93-7.08 for thyroid-stimulating hormone; 4.12 vs. 8.24-10.04 for free thyroxine; 0.49 vs. 0.82-0.91 for total triiodothyronine). The proportion of results exceeding absDCL of health screening differed from those of other clinical settings. Furthermore, sensitivity between health screening and other clinical settings was significantly different in both the result mix-up and sample mix-up datasets.
CONCLUSIONS: This study determined practical DCLs for TFTs and highlighted differences in absDCLs between health screening and other settings. These findings emphasize the importance of tailored DCLs in improving the accurate reporting of TFTs.
METHODS: Between 2020 and 2022, 610,437 paired TFT results were collected from six university hospitals. The absolute DCL (absDCL) was determined using the 95th percentile for each clinical setting from a random 60 % of the total data. These absDCLs were then tested within and across different settings using the remaining 40 % of the data, alongside mix-up datasets for result and sample comparisons. The sensitivities of absDCL were calculated within and across groups in the mix-up datasets.
RESULTS: Health screening absDCLs were notably lower than in other settings (2.58 vs. 5.93-7.08 for thyroid-stimulating hormone; 4.12 vs. 8.24-10.04 for free thyroxine; 0.49 vs. 0.82-0.91 for total triiodothyronine). The proportion of results exceeding absDCL of health screening differed from those of other clinical settings. Furthermore, sensitivity between health screening and other clinical settings was significantly different in both the result mix-up and sample mix-up datasets.
CONCLUSIONS: This study determined practical DCLs for TFTs and highlighted differences in absDCLs between health screening and other settings. These findings emphasize the importance of tailored DCLs in improving the accurate reporting of TFTs.
摘要：
背景：本研究旨在确定甲状腺功能测试（TFT）的实际delta检查限值（DCL），以检测各种临床环境中的样本错误识别。
方法：在2020年至2022年之间，从六所大学医院收集了610,437个配对的TFT结果。绝对DCL(absDCL)使用每个临床设置的第95百分位数从总数据的随机60%中确定。然后使用剩余的40％的数据在不同的设置内和跨不同的设置测试这些absDCL，与混合数据集一起进行结果和样本比较。在混合数据集中的组内和组间计算absDCL的敏感性。
结果：健康筛查absDCL明显低于其他设置（2.58vs.促甲状腺激素5.93-7.08；4.12vs.游离甲状腺素8.24-10.04；0.49vs.总三碘甲状腺原氨酸为0.82-0.91）。超过健康筛查absDCL的结果比例与其他临床环境不同。此外，在结果混合和样本混合数据集中,健康筛查和其他临床设置之间的敏感性存在显著差异.
结论：这项研究确定了TFT的实际DCL，并强调了健康筛查和其他设置之间absDCL的差异。这些发现强调了定制的DCL在改善TFT的准确报告中的重要性。
方法：在2020年至2022年之间，从六所大学医院收集了610,437个配对的TFT结果。绝对DCL(absDCL)使用每个临床设置的第95百分位数从总数据的随机60%中确定。然后使用剩余的40％的数据在不同的设置内和跨不同的设置测试这些absDCL，与混合数据集一起进行结果和样本比较。在混合数据集中的组内和组间计算absDCL的敏感性。
结果：健康筛查absDCL明显低于其他设置（2.58vs.促甲状腺激素5.93-7.08；4.12vs.游离甲状腺素8.24-10.04；0.49vs.总三碘甲状腺原氨酸为0.82-0.91）。超过健康筛查absDCL的结果比例与其他临床环境不同。此外，在结果混合和样本混合数据集中,健康筛查和其他临床设置之间的敏感性存在显著差异.
结论：这项研究确定了TFT的实际DCL，并强调了健康筛查和其他设置之间absDCL的差异。这些发现强调了定制的DCL在改善TFT的准确报告中的重要性。
