Hi John
Hope things ok with you.
We reported eGFR on all but 0.8% of the creatinines we sent out in May/June 2012: we don't report egfr on under-18s, which accounts for the 0.8%. All the practices in bath and NE somerset except two send all their samples to us (about 24 practices). We do report on >90y, and we report >90 mL/min.
Best wishes
A
-----Original Message-----
From: OConnor John (ROYAL DEVON AND EXETER NHS FOUNDATION TRUST)
Sent: 06 December 2013 10:43
To: Taylor Andrew (ROYAL UNITED HOSPITAL BATH NHS TRUST - RD1); [log in to unmask]
Subject: RE: for info - The NHS Atlas of Variation in Diagnostic Services
Hi Andrew
Do you report eGFR on patients <18 yrs and >90yrs and when the eGFR is going to be >90 ?
BW John
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Taylor Andrew (ROYAL UNITED HOSPITAL BATH NHS TRUST - RD1)
Sent: 06 December 2013 10:37
To: [log in to unmask]
Subject: Re: for info - The NHS Atlas of Variation in Diagnostic Services
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Big discrepancy between serum creatinine and eGFR rates - yet we report eGFR on every creatinine.
A
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Richard Stott
Sent: 06 December 2013 09:59
To: [log in to unmask]
Subject: Re: for info - The NHS Atlas of Variation in Diagnostic Services
Still wrong. We don't get insufficient sample for 80% of our primary care requests so the numbers reported back will be very similar!
Richard
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JONES Stuart (Pathology) (RF4) BHR Hospitals
Sent: 06 December 2013 09:54
To: [log in to unmask]
Subject: Re: for info - The NHS Atlas of Variation in Diagnostic Services
I think the data been pulled from PMIP rather than directly from GP's systems? It therefore reflects what labs are actually transmitting to GP's?
Stuart
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Richard Stott
Sent: 06 December 2013 09:45
To: [log in to unmask]
Subject: Re: for info - The NHS Atlas of Variation in Diagnostic Services
I looked at thyroid function too. Interesting but also very flawed because of how the data appears to have been obtained.
. We do TSH & fT4 on every request and have no mechanism to do any differently.
. It is difficult to identify which bar we might be on the histograms but the colours on the map would suggest a frequency of between 200 and 250 for TSH requests. If the frequency was the same for fT4 we would be among the highest requesting PCTs but the map suggests only about 50 / 10,000.
. I think we can safely conclude that they are collecting "numbers requested" on GP systems rather than "numbers of results returned". So in some/many areas it is actually telling us nothing other than which test is entered into the GP system to trigger the thyroid function testing process.
Their conclusions have no consideration of the inaccuracy in data gathering as a significant contribution to the variation although there is an inappropriate implication that many areas of the country do not follow the guidelines and should do so.
Regards
Richard Stott
Principal Clinical Scientist
Doncaster & Bassetlaw Hospitals NHS Foundation Trust
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JONES Stuart (Pathology) (RF4) BHR Hospitals
Sent: 06 December 2013 09:31
To: [log in to unmask]
Subject: Re: for info - The NHS Atlas of Variation in Diagnostic Services
Only just got round looking at this in detail. TFT data is particularly interesting - far more variation in FT4 testing than TSH. Must largely be a reflection of differing laboratory practice i.e. TSH only first-line vs TSH+FT4 vs whatever the GP asks for? Isn't it about time we tried to standardise our approach around best evidence?
Stuart
Stuart Jones | Principal clinical scientist Clinical biochemistry / Pre-natal screening King George Hospital Barking, Havering and Redbridge University Hospitals NHS Trust Barley Lane Ilford Essex
IG3 8YB
Technical lead | Lab Tests Online UK
http://www.labtestsonline.org.uk/
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Freedman Danielle (RC9) Luton & Dunstable Hospital TR
Sent: 28 November 2013 11:59
To: [log in to unmask]
Subject: FW: for info - The NHS Atlas of Variation in Diagnostic Services
Interesting stuff !
regards
Danielle
Dr Danielle B. Freedman MB BS, FRCPath,EurClinChem Divisional Director Diagnostics, Therapeutics and Outpatients Luton and Dunstable University Hospital NHS FT Luton, LU4 0DZ
+441582 497212
http://www.rightcare.nhs.uk/index.php/atlas/diagnostics-the-nhs-atlas-of-variation-in-diagnostics-services
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Travelling to Doncaster Royal Infirmary? Why not use the free Park & Ride service from Doncaster racecourse - free parking with free shuttle buses to and from the hospital every 15 minutes (6.30am-10pm, Mon-Fri).
Travelling between our hospitals? Why not use the free shuttle buses between:
Bassetlaw Hospital and Doncaster Royal Infirmary Montagu Hospital and Doncaster Royal Infirmary
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Travelling to Doncaster Royal Infirmary? Why not use the free Park & Ride service from Doncaster racecourse - free parking with free shuttle buses to and from the hospital every 15 minutes (6.30am-10pm, Mon-Fri).
Travelling between our hospitals? Why not use the free shuttle buses between:
Bassetlaw Hospital and Doncaster Royal Infirmary Montagu Hospital and Doncaster Royal Infirmary
This email is confidential, private and privileged. If you are not the intended recipient please accept our apologies. Do not disclose, copy or distribute information in this email or take any action in reliance on its contents; to do so is strictly prohibited and may be unlawful. Please inform us that this email has gone astray before deleting it. Thank you for your cooperation.
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