Reflective testing - what do our service users think?

Darby, D.A.; Kelly, Amanda

doi:10.1258/000456306778520016

Cited by 15 publications

(17 citation statements)

References 4 publications

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“…However, a study with respect to undertaking additional iron and Vitamin D studies has recently been reported 4 and another study of reflective testing of free triiodothyronine, g-glutamyltransferase, lipid profiles, thyroid peroxidase antibodies and other tests showed that both hospital and general practitioner (GP) users generally approved of this activity. 5 A brief and simple 'tick box', 5 level Likert type, questionnaire was drafted asking GPs and NPs whether they found comments helpful or not, whether the comments influenced patient management and whether they approved of laboratory staff doing 'add-on' tests.…”

mentioning

confidence: 99%

Do interpretative comments influence patient management and do our users approve of the laboratory ‘adding on’ requests? A follow-up General Practitioner and Nurse Practitioner survey

Barlow

2009

Ann Clin Biochem

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mentioning

confidence: 99%

Do interpretative comments influence patient management and do our users approve of the laboratory ‘adding on’ requests? A follow-up General Practitioner and Nurse Practitioner survey

Barlow

2009

Ann Clin Biochem

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“…Although reflective and reflex comments on laboratory reports are widespread 7,8 and generally appreciated by clinicians and the public, [11][12][13] evidence for their effectiveness is limited. 7,8 Reflective testing is a process whereby a laboratory specialist adds additional tests or individualised interpretative comments or both to aid the diagnosis and management of individual patients.…”

Section: Discussionmentioning

confidence: 99%

Do reflex comments on laboratory reports alter patient management?

et al. 2020

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Introduction Laboratory comments appended on clinical biochemistry reports are common in the UK. Although popular with clinicians and the public, there is little evidence that these comments influence the clinical management of patients. Methods We provided reflex automated laboratory comments on all primary care lipid results including, if appropriate, recommendation of direct referral to the West Midlands Familial Hypercholesterolaemia service (WMFHS). Over a two-year period, the number GP referrals from the Wolverhampton City Clinical Commissioning Group (CCG) to the WMFHS were compared with four comparator CCGs of similar population size, who were not provided with reflex laboratory comments. Results Over the study period, the WMFHS received more referrals from Wolverhampton GPs (241) than any other comparator CCG (range 8–65) and greater than the combined referrals (172) from all four comparator CCGs. Conclusion Targeted reflex laboratory comments may influence the clinical management of patients and may have a role in the identification of individuals with familial hypercholesterolaemia.

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“…3 There is certainly evidence that service users favour the provision of interpretative comments as well as appreciating additional testing, where appropriate. 4,5 It has also been established in a UK service that over 75% of the recipients of report comments feel they influence patient management, for some tests at least. 6 In a separate study, a temporal relationship between the introduction of thyroid comments and a subsequent reduction in the proportion of patients inadequately replaced with levothyroxine has been found.…”

Section: Discussionmentioning

confidence: 99%

A national survey of interpretative reporting in the UK

Freedman

2011

Ann Clin Biochem

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Aims: There is still debate as to whether the addition of interpretative comments to laboratory reports can influence the management of patients. Little is known about the extent of this activity in individual laboratories throughout the UK and so this national survey aimed to establish the prevalence. Methods: An electronic questionnaire was sent to 196 NHS laboratories in the UK asking whether 17 commonly requested groups of tests were reported with interpretative comments and, if so, how laboratory computers and/or humans were involved in the process. Enquiries were also made of the grades of staff performing the process and of any 'vignette' examples where interpretative reporting had improved the clinical outcome for the patient. Results: A total of 138 of the 196 laboratories (70%) responded. Only two laboratories did not have staff adding interpretative comments to any of the 17 tests. Consultant laboratory staff reporting predominated in all tests with a significant minority also being added by biomedical scientists. High-volume requests usually had staff adding comments to results selected by computer rules whereas more of the specialist endocrine tests tended to be considered for comment. Only six of 71 vignettes referred specifically to 'routine' biochemistry. Conclusions: The addition of interpretative comments onto clinical biochemistry reports is widespread throughout the UK. This service is largely consultant led. There is anecdotal evidence that the process can influence the clinical management of patients.

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Reflective testing - what do our service users think?

Cited by 15 publications

References 4 publications

Do interpretative comments influence patient management and do our users approve of the laboratory ‘adding on’ requests? A follow-up General Practitioner and Nurse Practitioner survey

Do interpretative comments influence patient management and do our users approve of the laboratory ‘adding on’ requests? A follow-up General Practitioner and Nurse Practitioner survey

Do reflex comments on laboratory reports alter patient management?

A national survey of interpretative reporting in the UK

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