JISCMail - ACB-CLIN-CHEM-GEN Archives

Help wanted!

Dear Colleagues, the "70% thing" refers to the percentage of medical decisions which are influenced by pathology tests.

Another view of this issue is the number of pathology tests which affect clinical decision making.

I am seeking assistance to try and find a paper, maybe over 10 years old, which followed the clinical response to tests reported to the emergency department. From memory potassium had an effect of most number of times and albumin never changed short term management.

If anyone can identify this paper for me I would be most grateful.

Thanks,

Graham

Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Ph: (02) 8382-9160
Fax: (02) 8382-2489

>>> Dennis Huckerby <[log in to unmask]> 10/07/2011 7:18 am >>>
Hi Mike, Rick and all

My reason for entering this chat line was because I remembered writing a
paper about this 70% and following an exchange of emails with you Mike over
the weekend, I realised that the ref in my earlier email was not the answer.
So digging around in my files I found my paper (MLW Sept 2002 Conspicuous by
its absence P 6 et seq) and apart from identifying the first quote of the
70% figure in an HSC Report, I was annoyed/disturbed/disgusted at the time
to find that neither the IBMS nor the ACB were represented as organisations
in the list of witnesses interviewed even though they may well have been
there as individual members.

However to cut a very long story short here is the ref for the HSC Report
and I then copy the intro to the Pathology Section. You can read the rest
for yourselves - -

<http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhe
alth/308/30802.htm>
http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhea
lth/308/30802.htm

Description: Description: House of Commons portcullis
House of Commons

Session 2001-02
<http://www.parliament.the-stationery-office.co.uk/pa/cm/cmpubns.htm>
Publications on the internet
<http://www.parliament.the-stationery-office.co.uk/pa/cm/cmhealth.htm>
Health Committee Publications

Health - First Report

_____

Here you can browse the report together with the Proceedings of the
Committee. The published report was ordered by the House of Commons to be
printed 1 May 2002.

CONTENTS – You can read these for yourselves when you go to this site.

As promised/threatened above here is the intro to the Pathology section –
please note #141 – but who/where was the analysis carried out??

VI PATHOLOGY AND PUBLIC PRIVATE PARTNERSHIPS

Pathology in the NHS

139. Our terms of reference extended to Public Private Partnerships. As we
noted above, The NHS Plan outlined areas for further collaboration between
the NHS and the independent sector. We chose to focus on pathology, one of
the key areas where the Department anticipates growth.

140. The estimated total NHS expenditure on pathology services was £742
million in 2000-01, an increase of nearly £200 million on the figure for
1998-99.[
<http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhe
alth/308/30809.htm#note231> 231] The Royal College of Pathologists estimates
that pathology consumes around 6% of the NHS acute services budget.[
<http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhe
alth/308/30809.htm#note232> 232] There are around 300 services in England,
usually based in acute trusts, and about 1700 separate laboratories
(principally haematology, microbiology, biochemistry, histopathology,
immunology). Historically, pathology laboratories developed on-site in
hospitals, serving local catchment populations. There are also approximately
250 private sector laboratories. There are a further 46 Public Health
Laboratory services.[
<http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhe
alth/308/30809.htm#note233> 233]

141. Up to 70% of all diagnoses in NHS patients depend on laboratory tests,
hence NHS pathology services are critical for the day to day evidence-based
care of patients. Fewer than 5% of test requests ("hot tests") require a
response within 24 hours. The NHS undertakes some pathology work for the
independent sector, but very little NHS work is currently undertaken by the
independent sector. In addition, the reprovision of laboratories has been
included in a number of PFI projects. Only about 5% of pathology work
undertaken in the UK is currently conducted by the private sector.[
<http://www.parliament.the-stationery-office.co.uk/pa/cm200102/cmselect/cmhe
alth/308/30809.htm#note234> 234]

I have to admit that I have not read thru the total report and it may well
mention somewhere more about the work carried out to support the 70% figure.
However if not then I am sure there are amongst you those who will know and
be able to contact some of the more prominent Pathology personnel eg – Prof.
Sir John Lilleyman and Karen Ward to mention just two

So hope this ramble helps you identify the source and accuracy of the 70%
figure and then I hope you will publish your findings----------PLEASE

Happy reading everybody……………………Dennis

------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
Green Laboratories Work
http://www.laboratorymedicine.nhs.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/

**********************************************************************
This email and any files transmitted with it are confidential and
intended solely for the use of the individual or entity to whom they
are addressed. If you have received this email in error please notify
the system manager.

This footnote also confirms that this email message has been virus
scanned and although no viruses were detected by the system, St Vincents &
Mater Health Sydney accepts no liability for any consequential damage
resulting from email containing any computer viruses.

**********************************************************************