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I have restrained myself from entering the saga of clinical validation of laboratory results both in and out of hours but have been finally provoked beyond endurance by Dr MacNamara's contribution. This I can paraphrase as 'give me what I want and give it me now' Unfortunately all medical staff are clearly not as familiar with the selection and interpretation of laboratory tests as Dr MacNamara. Indeed it is my experience that as we adopt PBL learning the knowledge base of clinical biochemistry amongst doctors is in the decline. The incidence of bizarre requests is increasing and the arguments put to justify them show a frightening ignorance even amongst more senior staff. This is of personal concern to me as I come to the age group where I am as likely to meet a doctor as a patient as a colleague. In my small paediatric lab looking at all reports is feasible during the day but I can understand that in general labs high throughput means that clinically validating all results is time consuming and boring. However, the use of a computer, delta checks and a few rules could allow the greater part of reults to be issued without checking leaving the more important results to occupy the clinical scientist or chemical pathologist. Out of hours requests will almost always fall into the group which can be automatically validated. Others have demonstrated that medical staff often value comments and find them useful inpatient management so the evidence base is there for Dr MacNamara but I suspect her practice is entirely hospital based while most UK labs have a large element of GP work. Perhaps this subject has reached it's natural end with fixed views based on different philosophies and resource driven practical approaches. We know preanalytical and postanalytical phases of lab tests are just as prone to problems as the analytical phase so will anyone kick off with an email on clinical validation of requests? Mike Addison Dr G.Michael Addison Royal Manchester Children's Hospital Pendlebury Manchester M27 4HA United Kingdom Tel 0161-727-2250(AM)or 0161-220-5342(PM) FAX 0161-727-2249 Email [log in to unmask]