I agree entirely. My comment was that I would contact the specialist lab for
advice so I could then dicsuss with my paediatricians. This got a low mark
but I thought that knowing one's own limitations was a very important part
of clinical governance.
I have noticed this with many of the cases. I think many of the assessors
take an academic biochemical view of the cases but I tend to get lowish
marks because I take a clinical view. e.g. I got marked down on one case for
saying that the first test one should to investigate amenorrhoea in a woman
in the fertile years was a pregnancy test. It doesn't matter if clinical
details state history of infertility; unless proven otherwise pregnancy is
the most likely cause of amenorrrhoea.
This does tend to make me question whether it is safe to continue doing the
cases because a persistently low average mark in any other QA scheme would
make you wonder whether you should be doing that test; in the clinical
cases, a persistently low average mark probably relates more to one's
personality and the way express complex information in a very tight space
limit.
TIM
****************************************************************************
*********
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email
connection doesn't work:
[log in to unmask]
****************************************************************************
**********
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> -----Original Message-----
> From: Eric Hindle [mailto:[log in to unmask]]
> Sent: 20 November 2002 12:41
> To: [log in to unmask]
> Subject: Report comments
>
>
> The most recent case for comment(131) has raised some
> important points on
> which I would welcome views.
>
> The most important relates to commenting on results which
> have not been
> produced in my own Laboratory. I would be interested to know
> how many of
> the 139 participants actually measure 17 alpha
> OH-Progesterone themselves.
> I suspect that the level is considerably less than 20%,
> meaning that a very
> large number of people have commented on results produced elsewhere,
> outside their control.
>
> I would expect any sample referred to a 'specialist' laboratory for a
> 'specialist' test to be commented on by the 'specialists' in that
> laboratory. I would almost never comment (nor add on
> additional comments)
> on a report of an investigation which I had not conducted. If
> I was asked
> an opinion on a referred test, then I might respond in
> general terms, then
> contact the 'specialist' laboratory direct if I needed an opinion or
> interpretation.
>
> What are the ethical, medicolegal and clinical governance
> issues around
> commenting on any result of a test which is not conducted in your own
> laboratory and of which method characteristics you have no knowledge?
>
> Is there also a 'best practice' about how reports from referral
> laboratories should be held in the referring Laboratory and/or medical
> records? I know this was the subject of some dicussion
> earlier.My practice
> has been to enter the referral laboratory, results and
> comments, into the
> computer, but not to issue my own laboratory's printed
> report. The printed
> report provided by the referral laboratory is dispatched for
> inclusion in
> the case notes, thereby avoiding transcription errors and ensuring the
> requesting doctor has direct access to any appended comment
> made by the
> referred laboratory 'specialist'. I realise this may have to
> change when we
> move to EPR. Comments, please (your own)!
>
> By the way, you may have gathered that I got an extremely low
> score on this
> return! Eric Hindle.
>
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