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Well, I'm glad I resuscitated the debate.

But please could proposals be linked to the supporting evidence? If not how are we going to be able to run any more EBLM meetings?

Jonathan

PS: I think it's inappropriate to put these comments in reports from a single analysis on a single subject when we have no or little information about the patient. How about hyperlinking to the best available evidence or policy instead? I think there's an ACB meeting coming up next year on this... 


On 2 Dec 2011, at 13:04, ANDREW WOOTTON wrote:

I would like to put in a bid for the inclusion of an additional “optimal” range:-
 
 
< 25 nmol/L :  vitamin D deficiency
 
25 - <50: vitamin D insufficiency
 
50 - 75: adequate vitamin D status
 
>75: optimal vitamin D status
 
BW Andrew
 
 
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri
Sent: 01 December 2011 14:51
To: [log in to unmask]
Subject: Re: Harmonising vitamin D reporting units
 
So the consensus is to use nmol/L in reporting serum vitamin D results, which is great.

Can we also reach a near consensus regarding cut-offs and associated comments that can be driven by LIMS, such as:
 
< 25 nmol/L : indicates vitamin D deficiency, suggest giving supplementation according to local guidelines.
 
25 - <50: indicates vitamin D insufficiency, advise increase sun exposure and/or giving vitamin D supplementation.
 
50 - 150: indicates adequate vitamin D status.
 
> 150 : indicates potential adverse effects, suggest reduce supplementation dose.
 
I would be grateful for your comments to help formulate our regional guidelines.
 
Regards
 
Mohammad
 



--- On Thu, 1/12/11, Stephen Davis (Cwm Taf Local Health Board - Clinical Biochemistry, Directorate of Pathology) <[log in to unmask]> wrote:


From: Stephen Davis (Cwm Taf Local Health Board - Clinical Biochemistry, Directorate of Pathology) <[log in to unmask]>
Subject: Re: Harmonising vitamin D reporting units
To: [log in to unmask]
Date: Thursday, 1 December, 2011, 14:24

OK, I’ll stick my head above the parapet wearing my hat as secretary for the All Wales Clinical Biochemistry Audit Group (AWCBAG);

 

In our case silence very much betokens assent.  When we recently surveyed practice within Wales half the labs (n=3) were already reporting in nmol/L, three used ug/L and one ng/mL. We have agreed to settle on nmol/L for reporting in future.

(Survey was undertaken by Therese Michael who, with Carol Evans and Dev Datta , put together draft standards which were presented at the AWCBAG meeting held on 17/11/11)

 

I wait to be flamed!

 

Steve

 

Steve Davis

Principal Biochemist

Royal Glamorgan Hospital

Ynysmaerdy

PONTYCLUN

CF72 8XR

 

Tel. 01443 443357

Fax. 01443 443355


From: Clinical biochemistry discussion list [mailto: [log in to unmask] ] On Behalf Of Jonathan Kay
Sent: 01 December 2011 13:31
To: [log in to unmask]
Subject: Harmonising vitamin D reporting units

 

Deafening silence... does it mean agreement, you don't want the argument or you're on strike?

 

Jonathan

 

On 28 Nov 2011, at 16:50, Jonathan Kay wrote:

 

Same principles as other analytes:

 

1 Consistency is a good thing

 

2 Units of measure should be ISO. In this case the authority is passed to IFCC/IUPAC. See 1966 decision. The appropriate unit is mol/ litre. 

 

3 Arguments that depend on current or historical practice are trumped by (2). If (3) isn't trumped by (2) how can we ever make progress?

 

4 Ad hoc groups, special interest groups and professional societies should be involved in improving consistency but shouldn't oppose (2). They have a crucial role in managing transitions.

 

5 Preference (like plumage) don't enter into it.

 

Jonathan

 

 

On 28 Nov 2011, at 12:38, Mohammad Al-Jubouri wrote:

 

Dear All,

 

What people think about this and what is the preferred unit of reporting?

 

thanks

 

Mohammad

Dr. M A Al-Jubouri, MB ChB, MSc, FRCP Edin, FRCPath
Consultant Chemical Pathologist

 


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