Using Machine Learning-Based Multianalyte Delta Checks to Detect Wrong Blood in Tube Errors.

Abstract

An unfortunate reality of laboratory medicine is that blood specimens collected from one patient occasionally get mislabeled with identifiers from a different patient, resulting in so-called "wrong blood in tube" (WBIT) errors and potential patient harm. Here, we sought to develop a machine learning-based, multianalyte delta check algorithm to detect WBIT errors and mitigate patient harm. We simulated WBIT errors within sets of routine inpatient chemistry test results to develop, train, and evaluate five machine learning-based WBIT detection algorithms. The best-performing WBIT detection algorithm we developed was based on a support vector machine and incorporated changes in test results between consecutive collections across 11 analytes. This algorithm achieved an area under the curve of 0.97 and considerably outperformed traditional single-analyte delta checks. Machine learning-based multianalyte delta checks may offer a practical strategy to identify WBIT errors prior to test reporting and improve patient safety.