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ACB-CLIN-CHEM-GEN  August 2013

ACB-CLIN-CHEM-GEN August 2013

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Subject:

Re: Instant test to see if you need antibiotics

From:

Karen Søeby <[log in to unmask]>

Reply-To:

Karen Søeby <[log in to unmask]>

Date:

Wed, 7 Aug 2013 20:16:44 +0200

Content-Type:

text/plain

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text/plain (435 lines)

It is true about the CRP POCT analysers being very very common at GPs in DK. But there is no rule as such about prescribing.  But it is definitely used very often. More often to convince patients that antibiotics are of no use in a viral infection. 
But what should also be noted are other incentives for performing the test. The GPs charge the national health for the service. And the tarif is more than the cost of reagents etc. The present tarif that the GPs charge the NHS is £6 on top on the consultation. 

The quality control of POCT analysers and the performance tests is often a topic for debate between clinical biochemists and GPs.

The price of CRP in our hospital  lab is similar to that of a UK NHS lab.

Best regards

Karen Søeby
Dept of Clinical Biochemistry
Roskilde Hospital
Denmark


Sendt fra min iPad

Den 06/08/2013 kl. 17.07 skrev "Mainwaring-Burton Richard (SOUTH LONDON HEALTHCARE NHS TRUST)" <[log in to unmask]>:

> Afinion analyser has a CRP cartridge option which is reputed (by the rep) to be in all GPs in Denmark who are not allowed to prescribe antibiotics without a raised CRP.
> Also does glycated Hb so the paediatricians like it
> 
> with best wishes
> Richard
> Richard Mainwaring-Burton
> Consultant Biochemist
> South London Healthcare Trust
> Queen Elizabeth Hospital, Woolwich
> Princess Royal Hospital, Farnborough
> Queen Mary's Hospital, Sidcup
> 020-8836-5724
> mob: 07831-739876
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Webster Craig
> Sent: 06 August 2013 16:00
> To: [log in to unmask]
> Subject: Re: Instant test to see if you need antibiotics
> 
> Full cost £1.27 price to a gp £0.80 price to trust £0.37 (this is price minus overheads)
> 
> 
> 
> From: "Heaney Katy (BARNET AND CHASE FARM HOSPITALS NHS TRUST)" <[log in to unmask]<mailto:[log in to unmask]>>
> Reply-To: "Heaney Katy (BARNET AND CHASE FARM HOSPITALS NHS TRUST)" <[log in to unmask]<mailto:[log in to unmask]>>
> Date: Tuesday, 6 August 2013 15:56
> To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
> Subject: Re: Instant test to see if you need antibiotics
> 
> 
> ---
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
> 
> The identified sender is [log in to unmask]<mailto:[log in to unmask]>
> ---
> 
> Anyone prepared to give a cost for their own CRP we can tell NHS Choices that the lab does offer already at this price... Be good to have a few from different Trusts to show its not just one trust that can offer this test at far less than what I assume is a POCT CRP test...
> 
> personel email me if you prefer and I will anonomise
> 
> Anyone care to give an guestimate of how many years CRP has been available in the laboratory, and available to GP practices.
> Any papers to quote when CRP is wrong?
> 
> thanks
> Katy
> 
> Katy Heaney
> POCT Manager and Principal Biochemist
> [cid:image004.png@01CD39C3.6DC62300]
> Department of Chemical Pathology
> Barnet and Chase Farm Hospitals
> Wellhouse Lane
> Barnet
> EN5 3DJ
> 
> Email:                     [log in to unmask]<mailto:[log in to unmask]>
> Telephone:            (020) 8216 4049
> 
> Lab tests: What is this test for? What does this result mean?
> http://www.labtestsonline.org.uk/
> 
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
> Sent: 06 August 2013 15:40
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Instant test to see if you need antibiotics
> 
> 
> ---
> 
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
> 
> 
> 
> The identified sender is [log in to unmask]<mailto:[log in to unmask]>
> 
> ---
> 
> NHS Choices are going to find it hard to keep up with the Daily Mail (actually this articles not too bad by their standards) Fantastic new test called CRP and it's only a finger prick away
> 
> 
> "Breakthrough could stop the over use (of antibiotics) that's fuelling the rise of superbugs"
> "Now a simple finger prick test could solve this catastrophic threat. The test which - which involves taking a drop of blood from the finger - can tell doctors within 3 minutes whether an illness is caused by a bacterial infection which requires antibiotics or a virus which does not"
> 
> "The test is only available in laboratories in the UK (it can be carried out privately for £50 pounds) because the NHS does not yet fund it in GP practices. The machine to analyse it initially costs £1000 and then £3 per test"
> 
> BW John
> 
> 
> 
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JONES Stuart (Pathology) (RF4) BHR Hospitals
> Sent: 06 August 2013 09:27
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Aldosterone assay requesting is likely to boom...
> 
> 
> As always, great myth-busting article in response from NHS choices: http://www.nhs.uk/news/2013/08August/Pages/No-cheap-cure-for-high-blood-pressure.aspx
> 
> "...it is hard to fathom on what the Mail Online is basing its claims that a "simple test could save thousands from life-threatening problems each year". "
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ian Young
> Sent: 05 August 2013 16:41
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Aldosterone assay requesting is likely to boom...
> 
> I heard Morris Brown talk (very persuasively) about this earlier this year.  However, the key diagnostic test which he suggested was an [11C]-metomidate PET-CT scan - not currently widely available!
> 
> The published paper says: "Primary hyperaldosteronism was diagnosed by an elevated aldosterone/renin ratio (ARR) and followed up by confirmatory studies (CT scan or MRI and/or adrenal venous sampling and/or [11C]-metomidate PET-CT scan".
> 
> As so often with the popular media, I think that something has been lost in translation.....
> 
> Best wishes
> 
> Ian
> 
> 
> Prof.Ian S. Young
> 
> Professor of Medicine and Director of The Centre for Public Health Queen's University Belfast
> 
> 1st Floor ICS B Block
> Royal Victoria Hospital
> Grosvenor Road
> Belfast
> BT12 6BJ
> Northern Ireland
> 
> tel: +44 (0) 2890 632743
> fax: +44 (0) 2890 235900
> email: [log in to unmask]<mailto:[log in to unmask]>
> 
> 
> 
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Heaney Katy (BARNET AND CHASE FARM HOSPITALS NHS TRUST)
> Sent: 05 August 2013 13:39
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Aldosterone assay requesting is likely to boom...
> 
> Is it definitely Aldosterone that they are recommending is done?
> 
> The article I can find for Prof Morris. Can anyone access the article?
> http://www.nature.com/ng/journal/vaop/ncurrent/full/ng.2716.html
> I can not read - ?but is it talking about a genetic test - ?£15 seems unlikely for that.
> 
> The BHF that co-sponsoered the research doesn't mention a £15 test http://www.bhf.org.uk/media/news-from-the-bhf/curable-blood-pressure.aspx
> 
> Aldosterone assays provider- would it cost us £15 to send you a sample for Aldosterone?
> 
> Where have they got this figure from?
> 
> 
> 
> 
> Katy Heaney
> POCT Manager and Principal Biochemist
> 
> Department of Chemical Pathology
> Barnet and Chase Farm Hospitals
> Wellhouse Lane
> Barnet
> EN5 3DJ
> 
> Email:                     [log in to unmask]<mailto:[log in to unmask]>
> Telephone:            (020) 8216 4049
> 
> Lab tests: What is this test for? What does this result mean?
> http://www.labtestsonline.org.uk/
> 
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
> Sent: 05 August 2013 12:59
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Aldosterone assay requesting is likely to boom...
> 
> ---
> This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
> 
> The identified sender is [log in to unmask]<mailto:[log in to unmask]>
> ---
> Craig, this is a clear example of biochemical schadenfreude Shame on you :P)
> 
> BW John
> 
> -----Original Message-----
> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Webster Craig
> Sent: 05 August 2013 12:46
> To: [log in to unmask]<mailto:[log in to unmask]>
> Subject: Re: Aldosterone assay requesting is likely to boom...
> 
> Aldosterone available at Birmingham heartlands hospital!
> 
> :-)
> 
> Sent from my iPhone
> 
> On 5 Aug 2013, at 12:42, "Reynolds Tim (RJF) BHFT" <[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]>> wrote:
> 
> 
> http://www.dailymail.co.uk/health/article-2384450/Cheap-cure-thousands-high-blood-pressure-Simple-test-save-thousands-life-threatening-problems-year.html
> 
> 
> 
> 
> **************************************************************************************
> Prof. Tim Reynolds
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