Dear Helen
I don't know the evidence base behind the use of testosterone implants in
post-menopausal women. However, I am reminded of a quotation by Venise
Hewitt many years ago: 'if the testis withered on the vine like the female
ovary at the age of 50, every Gentleman's toilet between Bognor Regis and
Benbecula would have a testosterone vending machine'.
Joking apart, you raise a fundamental question about the role of the
Clinical Biochemistry laboratory, which previously surfaced some months ago.
On the one hand, should we be simply there to carry out 'evidence-based'
laboratory investigations relating to prescribed clinical conditions
according to defined SOPs and accredited by CPA, or should we have a rather
wider role?
We are all professionals, and obviously we should not undertake
investigations which are beyond our competence, either in analysis or in
interpretation. But I feel extremely strongly that
1. The Community needs an analytical service which is prepared to go rather
beyound a totally narrow 'clinical analysis' remit. Such service is not
necessarily provided by other analytical professions.
2. Where we feel capable, we should be prepared to extend our range of
analytical services offered to help solve some of the more esoteric problems
which come our way. This is to the benefit of the advancement of our
subject, of the Community, of the people who work in our laboratories, and
of ourselves.
3. By doing so, we may be vulnerable to accusations that 'this is not within
our remit' or 'where is the evidence that we are capable of carrying out or
interpreting results in this area?'. But I repeat, we are professionals who
are highly qualified, who should be able within our areas of expertise to
help solve analytical problems, and who should be able to defend our
analyses and our interpretations to the public and even if needed in a law
court. As a profession, we have over many years tended to deprecate our own
abilities: we are all brilliant, and shouldn't be afraid of the chance to
prove it (even if on occasion we get it wrong).
I think the profession will be a lot poorer if we hide ourselves behind a
narrow remit of 'CPA-approved' and refuse to tackle anything beyond this.
Nor do I believe that CPA would be happy with the idea that the
accreditation process should be a restriction on what we attempt to do.
Best wishes
Gordon Challand
----- Original Message -----
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Sent: Wednesday, August 06, 2003 11:11 AM
Subject: Testosterone Impants _ Case 147
> Are there reputable case studies behind the use of testosterone implants
in
> post menopausal women, or is their use extremely debatable?
> A high scoring comment for this case, was to send the implant to the
> laboratory for analysis, but does Accreditation allow a laboratory to
> report on a sample with a matrix which differs to the "normal" matrix
> assayed, and for which there is no external Quality Assessment?
>
> ____________________________________________________________
>
> Dr. Helen Grimes, Dept. of Clinical Biochemistry, UCH, Galway, Ireland
>
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------ACB discussion List Information--------
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via the internet. Views expressed are those of the individual and
they are responsible for all message content.
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