Perhaps seeing others' responses to a few examples might draw out the
issues:
How would you respond in each of the following situations:
(Do the extra assays, talk to the clinician before doing them, do
nothing, something else)
1 Adding other thyroid-related assays after seeing the result after
receiving a request for TSH
2 Adding other thyroid-related assays after seeing the TSH result after
receiving a request for "thyroid function tests"
3 Adding hCG assay to a sample from a young woman with suppressed
gonadotrophins
4 Adding a tumour marker assay on a hypercalcaemic sample with
suggestive clinical details.
5 Adding total protein assay to a request for "LFT" in order to detect
asymptomatic paraproteinaemia
6 Adding GGT assay after seeing the results following a request for
"LFT"
Jonathan
On 20 Feb 2004, at 11:06, Andy Ellis UK NEQAS wrote:
> Whilst the regulations / law remain unclear, the safest policy seems
> to be
> to never instigate cascade requesting without speaking to the
> requesting
> clinician first. This might appear to be somewhat detrimental to
> patient
> care in the short term but the phone call should not take too long and
> would
> ultimately be of benefit to patient, requester and laboratory, as well
> as
> covering the laboratory,
>
>
>
> From: "John Rattenbury" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, February 20, 2004 10:09 AM
> Subject: Re: Progress on the Human Tissue Bill
>
>
>> Brilliant responses but not certain my original question has been
> answered.
>> Some more specific examples: adding hCG to a sample from a young woman
>> with suppressed gonadotrophins, adding a tumour marker to a
>> hypercalcaemic
>> sample with suggestive clinical details. These, and others too
>> numerous to
>> mention, would be 'sensitive' areas. I have already had a request
>> refused
>> to forward a spare blood spot from neonatal screening for
>> immunoreactive
>> trypsin also to be done on the grounds that consent had only been
>> given
>> for the agreed screening.
>> Do we give up pro-activity? Are the lawyers circling?
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|