To Reflex or Not to Reflex: A Time and Cost-Effectiveness Analysis of Autocontrol with Reflex DAT versus Direct DAT.

Objective: Performing autocontrol with a reflex direct antiglobulin test (DAT) or directly performing IgG DAT only for alloantibody detection has been a matter of institutional preference. The aim of this study is to evaluate antibody identification (ABID), local cost, and staff time savings of both processes.

Methods: We retrospectively reviewed all positive indirect antiglobulin tests with corresponding ABID, DAT, autocontrol, and patients with newly identified antibodies in 2014 and 2016.