Dear Collective Brain
The maintenance and updating of the Pathology Bounded Code List (PBCL) is overseen by the Pathology Catalogues Executive Team (PCET) at the College - more can be found on the College
website.
Last week PCET discussed two issues about naming and reporting but wish to have a wider review before finalising our recommendations.
There is a legal requirement to report blood lead concentrations as ug/dl rather than SI units - The
Control of Lead at Work 2002 and yet for clinical purposes most labs will use SI units.
The PCET proposed mitigation is that blood lead requests could be differentiated as being associated with the monitoring of lead workers
eg Blood Lead (Occupational) reported in ug/dL and for other clinical purposes Blood Lead (Clinical) in umol/L.
This creates two report items for the same assay but avoids two sets of units for the same assay.
The second issue was raised by GPs in relation to HbA1c being used both for monitoring glycaemic control and in the diagnosis of diabetes. The
use of NICE guidance as action indicators with HbA1c reports hides elevated values when the same assay is being used for diagnostic purposes. Elevated values may be considered ‘satisfactory’ when in fact they are indicating a new diagnosis of diabetes.
The proposed PCET mitigation is to create two report items in PBCL
Glycated haemoglobin (monitoring) and Glycated haemoglobin (diagnostic). This will allow appropriate interpretive comments to be made for both
purpose of use of the assay.
Your views on these proposals will be very welcome
Regards
Gifford
Dr Gifford Batstone
MBBS, BSc, FRCPath, MSc
Chair PCET
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