I am strongly in favour of reporting only the adjusted (corrected) calcium
concentration. When we reported both it was not unknown to find patients being
given vitamin D for a low total calcium when their adjusted value was normal.
The reference ranges should be identical (see, for example, Barth JH et al, Ann
Clin Biochem 1996; 33: 55-58, last paragraph)
Brian Payne
Frank Alvaro wrote:
> 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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