The assessment of interpretation in clinical biochemistry: a personal view

Challand, G S; Vasikaran, Samuel

doi:10.1258/000456307780118163

Cited by 13 publications

(6 citation statements)

References 8 publications

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“…Most UK laboratories have a Duty Biochemist (a suitably qualified senior medical or scientific professional) who adds interpretative comments on certain biochemistry reports, where the additional comment is considered to 'add value' to the requesting doctor or nurse. These activities have been considered in this journal on many occasions, 1,2 but even today there is little evidence that the activity is effective or appreciated by users of the service.…”

Section: Introductionmentioning

confidence: 99%

Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey

Barlow

2008

Ann Clin Biochem

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Background: Adding or incorporating clinical interpretative comments on biochemistry results is widespread in UK laboratories; although this consumes considerable human resource, there is still little evidence to suggest that it is either effective or appreciated by our clinical colleagues. I therefore decided to survey our local general practitioners (GPs) and nurse practitioners to analyse whether they found biochemistry comments on reports helpful. Methods: A simple questionnaire was designed and sent to 159 GPs and 81 nurse practitioners asking them whether they found this activity useful for the limited range of test groups that we routinely comment on and also whether they would like to see commenting on more groups of tests. Results: Overall, 49.6% of questionnaires were returned. Of these, there was overwhelming support for commenting on reports and 77% would like to see comments on a greater range of tests. Conclusions: Although adding clinical interpretative comments is very time-consuming for senior laboratory staff, there is overwhelming support of this activity among our GPs and nurse practitioner users; therefore, our local policy of routinely adding clinical comments will remain for the foreseeable future.

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Section: Introductionmentioning

confidence: 99%

Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey

Barlow

2008

Ann Clin Biochem

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“…In any case, even the quality of the interpretation offered by an expert system will be depend-ent on the knowledge and commenting skills of the person building the knowledge base. Proficiency testing of this activity has only recently been attempted (22). Narrative interpretative comments are still a voluntary and unregulated aspect of a laboratory result.…”

mentioning

confidence: 99%

Quality of interpretative commenting on common clinical chemistry results in the Asia-Pacific region and Africa

Vasikaran¹,

Lai²,

Sethi

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Interpretative commenting is an important activity of the clinical diagnostic laboratory. We describe a study of interpretative commenting abilities among senior laboratory professionals in the Asia-Pacific region and Africa. Methods: Five sets of laboratory results reflecting common and important problems encountered in clinical chemistry were distributed at 4-weekly intervals to 31 registered participants from countries in the Asia-Pacific region and Africa. Participants were asked to attach an interpretative comment to the results assuming that the requesting doctor had asked for an interpretation of the result. Results: Twelve pathologists and 19 scientists from seven countries registered to participate and the overall reply rate was ;50% for the five cases. The quality of the comments returned by participants was diverse and some reflected incorrect or misleading interpretation and advice. Conclusions: While interpretative commenting is an important laboratory activity, the results of this study suggest that there is room for improvement in the quality of interpretative comments offered by senior laboratory professionals, even for commonly reported results relating to most prevalent and important public health conditions. Interpretative commenting should be formally taught during training of patho-

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“…There is some evidence that they lead to improved outcomes compared to reports without comments [13]. The quality of interpretive commenting in clinical chemistry has been assessed by proficiency testing schemes and has found that unacceptable interpretation can be made [14][15][16][17] and lead to the conclusion that formal training of pathologists and clinical scientists should be provided [18][19][20], concentrating on how to comment as much as what to comment [21,22].…”

Section: The Post-analytical Phasementioning

confidence: 99%

Performance criteria of the post-analytical phase

Sikaris¹

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Quality in healthcare is ideally at an optimal benchmark, but must be at least above the minimal standards for care. While laboratory quality is ideally judged in clinical terms, laboratory medicine has also used biological variations and state-of-the-art criteria when, as is often the case, clinical outcome studies or clinical consensus are not available. The post-analytical phase involves taking quality technical results and providing the means for clinical interpretation in the report. Reference intervals are commonly used as a basis for data interpretation; however, laboratories vary in the reference intervals they use, even when analysis is similar. Reference intervals may have greater clinical value if they are both optimised to account for physiological individuality, as well as if they are harmonised through professional consensus. Clinical decision limits are generally superior to reference intervals as a basis for interpretation because they address the specific clinical concern in any patient. As well as providing quality data and interpretation, the knowledge of laboratory experts can be used to provide targeted procedural knowledge in a patient report. Most profoundly critically abnormal results should to be acted upon to minimise the risk of mortality. The three steps in quality report interpretation, (i) describing the abnormal data, (ii) interpreting the clinical information within that data and (iii) providing knowledge for clinical follow-up, highlight that the quality of all laboratory testing is reflected in its impact on clinical management and improving patient outcomes.

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The assessment of interpretation in clinical biochemistry: a personal view

Cited by 13 publications

References 8 publications

Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey

Are biochemistry interpretative comments helpful? Results of a general practitioner and nurse practitioner survey

Quality of interpretative commenting on common clinical chemistry results in the Asia-Pacific region and Africa

Performance criteria of the post-analytical phase

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