Up until a few weeks ago, we reported total serum calcium (with an
associated, age-related reference range) as well as a corrected calcium
(without any quoted ref. range). After an approach by some medical staff,
we started reporting a reference range for the corrected calcium as well,
using an identical range as used for the total calcium.
Now, we've been told by other medical staff that highlighting an abnormal
total calcium (our computer highlights - on screen and in hard copy - any
results outside its ref. range) when the corrected calcium is within range
is non-sensical, as it's the corrected calcium that is clinically important.
All this leads to a few questions:
1. should the quoted reference range for corrected calcium be the same as
for total calcium (it seems to me that logically it should be, but there
have been some murmers of uncertainty)
2. what abnormal result should we highlight (or not)? Should we overlook
(ie don't flag) an abnormal total calcium if the corrected calcium is
normal? Or, to take it to the extreme, should we just report the corrected
calcium (and albumin) and leave the measured total calcium unreported?
I'd appreciate any comments.
Frank Alvaro
Senior Hospital Scientist
Clinical Chemistry
South Western Area Pathology Service
Sydney, Australia.
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