A-370 High Rates of Potassium, Chloride and Hemoglobin Discordances in Split Samples Drawn within 1 minute and Analyzed on Point of Care GEM 5000 and Central Laboratory Roche Cobas 8000 and Sysmex Analyzers
Bibliographic record
Abstract
Abstract Background Previously, we used serial intensive care unit patient data as well as split sample glucose comparisons to characterize the analytical performance of the GEM 4000 and its tendency to generate outliers in the early to late evening. In this work, we summarize the discordance rate of 2 years of split specimens (minimally 17 700 patient care samples) that were drawn within 1 minute of each other and analyzed on the GEM 5000, Roche Cobas 8000 and Sysmex analyzers. Methods Two years (2020 and 2021) of GEM-central laboratory Cobas 8000 and Sysmex comparisons were obtained for potassium, sodium, chloride, glucose and hemoglobin (Sysmex). We used the GEM's iQM2 control (drift) limits to define discordant differences between the GEM and Roche/Sysmex analyses. We graphed the differences vs time of day and applied Dahlberg's formula to derive the magnitude of the running variation of the differences. Results The Table summarizes the drift limits, the number of comparisons performed over the two-year period and the average incidence of discordances over the 24 hour period. What strikes the casual observer is the asymmetric distribution of the discordances. More subtle is the lower frequency of potassium and hemoglobin discordances in the early morning and the higher frequency in the late afternoon and evening. The Dahlberg running variation graphs readily demonstrate this diurnal pattern. Conclusion The GEM 5000 overcalls increases in potassium, decreases in chloride and increases in hemoglobin. We recommend that other laboratories verify these findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".