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'Standardisation' means different things to different people and there are many processes within the whole area of laboratory medicine that might/could/should be 'standardised'. The question therefore needs to be broken done into chunks, which we could then debate. To my mind these are: [1] Standardisation of knowledge about the normal and pathological state (what is the correct 'marker' to measure, what can we actually 'measure' with today's technology, can we truly 'measure' all of these entities in the strict metrological sense anyway?) [2] Standardisation of clinical care (what you 'test' to rule in / rule out / screen / monitor for diseases x, y, z, what reference ranges do you use and the decision rules used to maximise the benefit for the patient of the knowledged gained) [3] Standardisation of the overall investigation process (infrastructure, staffing, organisation, preanalytics, analytics, post analytics, IT, communication) [4] Standardisation of 'results' - (why do 'methods' for the same 'analyte' give markedly different numerical results? How do you decide who is 'right'? Why do some suppliers market different instruments / reagents / calibrants which generate different numerical results for the same analyte. Why is the range of results from a single 'method' group for some analytes so large?) When you actually ask laboratories (as we often do in UK NEQAS) about their 'methods', calibration, reference ranges, procedures, interpretation, we get a very broad range of responses which would amaze/alarm the lay person and politician. Standardisation of course must not mean 'fossilisation' (a danger when the evidence base is a large study using 'old' technology that may never be repeated). There has to be a 'fuzzy edge' that allows innovation, questioning and quality improvement! On the other hand standardisation as a result of 'everyone has always done it this way' doesn't mean it is right either! I could make an attempt to answer all of these questions, but each would be an essay. Regrettably, like most of us, I don't have the time right now and have already spent too long on this reply! Nevertheless, I hope this contributes to the debate Rick! Jonathan On 2 Jul 2002, at 16:41, Rick Jones wrote: > Why is no-one debating the Path Mod Guidance? > > What are people's views on standardisation - does anyone have views > on the question in the guidance document. > > Should standardisation be at supra-StHa or National level and if so > how could it be best managed and coordinated? > > > > > > > > > > Dr Rick Jones > Director of Chemical Pathology and Immunology > Pathology Directorate > Leeds Teaching Hospitals Trust > Tel:(44)-113-233-5677 > Fax:(44)-113-233-5672 > http://www.acb.org.uk > http://www.yichi.org.uk > http://www.leedsteachinghospitals.com > http://www.leeds.ac.uk/rdinfo //Winner - Best Health Database HC99 > > ------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/ ============================================ Jonathan Middle, UK NEQAS Birmingham tel 0121 414 7300 fax 0121 414 1179 This message is intended only for the above recipient(s). The opinions expressed are mine alone and do not necessarily represent those of UK NEQAS Birmingham, the University Hospital Birmingham NHS Trust or the UK NEQAS Organisation. ================================================== ------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/