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Hi, I have found this discussion very informative and with the various initiatives of the ACB, IFCC, JCTLM and others, perhaps not quite such an unassailable mountain as first appeared. Those who have access to the latest issue of Chemistry World, the RSC magazine, may be interested in the article by Mike Sargent, Chief Chemical Metrologist at LGC, entitled 'Made to Measure' (Sep 2006, vol 3, issue 9, p46). 'The familiar ways of reaching consensus about measurements are leading chemists into troubled water.' In brief the chemists are looking at exactly the issues we are and broadly suggesting similar solutions. Only the abbreviations have changed! For ACB, IFCC and JCTLM read NIST, REMCO and 'ERM'. Indeed the aspirations of our chemical colleagues make ours in clinical biochemistry seem quite modest: Quote- 'Applying a single scheme of traceable measurements across all areas of chemistry and biology will achieve the same ambition that brought so many scientists to Paris in 1875.' In the short term this duplication of effort of course may be confounding. For example, whilst we may have the ear of our corporate colleagues in our field, their company's manufacturing arms will have their ear towards the chemical committees. There is also the question of who the 'little man in Whitehall' (or Brussels or Capital Hill) will listening to. However in the longer term broadly similar concepts of traceability, comparability and quality assurance are encouraging. The article includes a table of abbreviations of organisations involved in standardisation; namely BAM, BCR, BIPM, CIPM, IRMM, ISO, LGC, NIST, REMCO, UKAS and VAM. Perhaps someone could produce an equivalent table for abbreviations of Clinical Biochemistry Organisations and committees. I tend myself to agree there is no magic bullet but that the professions and other bodies with a will should be able to make significant quick gains on method comparability, while perhaps there is more steady progress on the fundamentals. Even if a final solution to traceablity does take another 130 years it will benefit future generations of healthcare professionals. (An interesting though separate thread would be to guess at the abbreviations of their titles.) Regards Steve Where there is discord let there be harmony. [log in to unmask] Subject: Clinical transferability of reports Ceridwen Coulson wrote: So,how do we make this happen? A quick brain dump: 1 Recognise that it is important, and that it may require lots of local changes, including methods, platforms, handbooks and reference intervals. 2 Require it in procurement. 3 Lots of work on harmonisation along the lines that Bart Ballieux has described. 4 Identify and deliver some early winners. 5 Find a professional route for addressing the relevant analytical and metrological issues, including those that Jonathan Middle and and Roger Ekins have identified in this mailgroup. This will be difficult when there are clashes between eg analytical traceability and clinical transferability. 6 End the confusion between the two meanings of test: test = assay and test = a procedure that adds clinical information. Jonathan On 1 Sep 2006, at 13:20, Ceridwen Coulson wrote: So,how do we make this happen? What are the blocks and impediments in the way? Where method differences preclude common reference intervals can't we devise some way of getting around the situation? Julian Barth is following this up with ACB,but,I agree with James,it's slow.Is the ACB the only professional body interested? Ceridwen -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]]On Behalf Of Jonathan Kay Sent: 01 September 2006 12:36 To: [log in to unmask] Subject: Clinical transferability of reports I was about to reply along exactly the same lines as James. (But I would describe what we need as "clinical transferability" rather than "common reference intervals".) This lack of transferability impedes attempts at knowledge management for laboratory medicine, as well as the development of computerised patient records. It's probably also clinically dangerous. See also the previous debate about glycated haemoglobin. The irony of course is that for domains where text is the output (eg radiology reports) the problem is less acute, as clinicians always have to try to understand what is in the report, and know that eg different radiologists report differently. (And that intentionally says "acute" and not "serious".) Jonathan _____ size=2 width="100%" align=center> From: Hooper James Sent: 01 September 2006 12:24 To: 'Hullin Dave' Subject: RE: LDH Yet another reason for having national reference intervals! We shoot ourselves in the foot as far as governmental agencies are concerned. Here we are, probably the most computer-conscious discipline within medicine, supporting the electronic health record (available anywhere nationally) and we can't even agree common reference intervals! We don't need endless debates about minor method differences - it's the outcome that matters. We need to move quickly for credibility's sake. 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