On the Use of Accuracy in Optimized Delta Check Rules for Detecting Misidentified Specimens in Children: The Authors’ Reply

Rui Zhen Tan, Corey Markus, Kay Weng Choy, James C.G. Doery, Tze Ping Loh

Research output: Contribution to journalLetterpeer-review


We thank Drs Baskin and Naugler for their insights and commentary on our article.1 We noted that alternative terms have been used in place of diagnostic accuracy, including diagnostic efficiency and diagnostic effectiveness. In clinical literature, the preferred term is diagnostic accuracy, as described in the Standards for Reporting of Diagnostic Accuracy (https://www.equator-network.org/reporting-guidelines/stard/). Furthermore, when used as a search term in PubMed, diagnostic accuracy produced 42,680 hits in comparison to 2,130 hits for diagnostic efficiency; in Google Scholar, this was 1,670,000 vs 29,300. In our article, we have carefully defined the term accuracy, including the mathematical formula. We did not make any reference to analytical performance of the tests (bias or trueness). The probability of readers confusing these terms is low. Finally, we wish to highlight that diagnostic efficiency has been used in the context of inappropriate laboratory test utilization.
Original languageEnglish
Pages (from-to)573-574
Number of pages2
JournalAmerican Journal of Clinical Pathology
Issue number4
Publication statusPublished - Oct 2020
Externally publishedYes


  • clinical literature
  • diagnostic accuracy
  • diagnostic efficiency
  • diagnostic effectiveness
  • Delta Check Rules

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