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As I see it, this test should not be automated. To do so would simply facilitate the analysis to be inappropriately performed on more people. Like so much of what we do, providing this analysis easily, feeds the myth that it somehow part of the diagnostic pathway for the investigation of headache. I'm afraid there are very few hospitals where the decision to perform the analysis is taken by a senior clinician. The lumbar puncture is often performed in the evening because it's easier when the ward is quiet. To facilitate the discharge of of an elderly person to a cold lonely house late at night having previously (often inexpertly) removed CSF by lumber puncture is not in the patient's best interests. The vanishingly low detection rate of genuine positives suggests that we are testing the wrong patients. Let's see this in the context of the whole patient pathway, Regards, David ------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/