Dr K Chan in Belleville, Canada asked about changing or factoring reference
intervals for LDH. Leaving aside whether LD should be measured at all
(indicated at least for following melanoma and lymphoma) the question is
whether a larger jump in reference interval can lead to significant
problems for the users.
We recently changed our lipase method to a method which gave values
approximately 1/3 of the previous method. We were concerned that the
clinicians memory of the meaning of results from the old assay may cause
problems. We wrote to all our users telling them it was happening (and
why), put a foot note on the new results for 3 months, and changed the
reference interval. The response: silence! No questions, comments or
complaints.
While I obviously cannot exclude any problems my advice is to make the
changes required rather than correlating with the past.
I hope these thoughts are helpful.
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|