What wil probably happen is that some ?bright individual will suggest we should report all results as multiples of the upper limit of the reference range - which would be an effectively unit-free value.
This will dump us in the same statistical mire that afflicts Down's screening (multiples of the median are rubbish at dealing with bias) and the quality of science in medicine will continue to slip back until we are in the dark ages again.
On the bright side, it will be much cheaper to diagnose diabetes by drinking urine so the Government will finally be happy because the cost of pathology will decrease.
TIM
*************************************************************************************
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email connection doesn't work:
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> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]]On Behalf Of Martin Holland
> Sent: 14 October 2004 12:30
> To: [log in to unmask]
> Subject: Re: Aggregation of reports from nontransferable methods
>
>
> Surely a local viewer will require only one set of units and reference
> ranges for the local cumulative data. The problem will arise
> when national
> or international organisations want to use global data.
>
> Regards,
>
> Martin.
>
>
> -----Original Message-----
> From: Mainwaring-Burton Richard (RGZ)
> [mailto:[log in to unmask]]
> Sent: 14 October 2004 12:26
> To: [log in to unmask]
> Subject: Re: Aggregation of reports from nontransferable methods
>
>
> Is this really a feasible solution ?
> If a local viewer is wanting to look at a cumulation of LFT
> results, they
> will not want the screen cluttered up with units and
> reference ranges for 8
> or 9 analytes on successive dates (who would?). As a result
> they are going
> to omit these items from their view, just as we all see in clinical
> presentations including alk phos results gleaned from notes.
> We already have
> problems with creatinines in µmol/L and mmol/L, troponins T & I called
> 'troponin', adjusted calcium, digoxin in ng/mL, µg/L, nmol/L etc. etc
>
> with best wishes
>
> Richard
>
> Richard Mainwaring-Burton
> Consultant Biochemist
> Queen Mary's Hospital
> Sidcup, Kent
> DA14 6LT
> 020-8308-3084
>
>
> -----Original Message-----
> From: Griffiths Paul (RQ3) BCH [mailto:[log in to unmask]]
> Sent: 14 October 2004 11:59
> To: [log in to unmask]
> Subject: Re: Aggregation of reports from nontransferable methods
>
>
> Jonathan,
>
> This was raised by several of us at a clinical engagement session on
> orders/reporting in the NWWM cluster. As I understand it the
> result will be
> transmitted together with the appropriate reference range
> attached and this
> will form part of the record. However I agree that this may
> then be used out
> of context. I also agree about the non-transferability of
> results, however
> one only needs to look at the range of results for EQA data
> to see that even
> labs using the same methods can vary greatly in their results
> for individual
> specimens/analytes.
>
> Regards
>
> Paul Griffiths
> Birmingham Children's Hospital
>
>
> -----Original Message-----
> From: Jonathan Kay [mailto:[log in to unmask]]
> Sent: 14 October 2004 11:22
> To: [log in to unmask]
> Subject: Aggregation of reports from nontransferable methods
>
>
> Yes, it's an enormous problem.
>
> I've noted this with NPfIT, but I don't think it is identified in any
> of their documents.
>
> Jonathan
>
> PS: I think this nontransferability reflects badly on our
> profession...
>
> On 14 Oct 2004, at 09:24, Mainwaring-Burton Richard (RGZ) wrote:
>
> > I have a serious concern in this regard relating to coding and the
> > centralisation of records. As we are using a variety of
> tehniques for
> > estimation of parameters, there are inevitably going to be
> variations
> > in
> > reference ranges and units between result providers. Alkaline
> > phosphatase is
> > the classic example. Hence the coding system will have to
> reflect these
> > variations when the results are uploaded from our
> laboratory systems
> > onto
> > the ICRS in the sky so that the results can be meaningfully
> filed and
> > compared by the viewers. Does anyone know of anyone else who is a)
> > concerned and b) addressing the issue ?
> >
> > with best wishes
> >
> > Richard
> >
> > Richard Mainwaring-Burton
> > Consultant Biochemist
> > Queen Mary's Hospital
> > Sidcup, Kent
> > DA14 6LT
> > 020-8308-3084
> >
> >
> > -----Original Message-----
> > From: gordon.challand [mailto:[log in to unmask]]
> > Sent: 14 October 2004 00:02
> > To: [log in to unmask]
> > Subject: Re: C-NPU
> >
> >
> > Dear Urban
> > I simply enquired how many labs in the UK were using IUPAC coding
> > numbers.
> > From the deafening silence from almost all of the
> participants in the
> > UK ACB
> > mailbase (half of which are outside the UK) I infer virtually none
> > are. This
> > is not related to the insular minds of the Albions (whatever that
> > means) nor
> > to any argument about what might or might not be 'metrologically
> > correct'
> > (whatever that means).
> > I'm old enough to remember being asked to comment on an
> IFCC document
> > which
> > related to definitions without any units attached to them (ie simple
> > numbers). The proposed IFCC definition at that time was
> 'entitities'. I
> > don't know how much time or expense was embarked on by the IFCC at
> > that time
> > to establish this basic premise; but even thirty years later I am
> > astonished
> > at the gulf between what might be called metrological purists, and
> > those who
> > have to try to convert numericl values into terms which might be
> > understood
> > by the patient, by the clinician, by the layman, and by the
> > politician. Can
> > some of you please 'get real' to the gulf between how we express our
> > results, and how we convert those results into terms which are
> > comprehensible to the outside world.
> > With best wishes
> > Gordon Challand
> > ----- Original Message -----
> > From: "Urban Forsum" <[log in to unmask]>
> > To: <[log in to unmask]>
> > Cc: "Anders Kallner" <[log in to unmask]>; "Jean-Claude
> > FOREST"
> > <[log in to unmask]>; "Muller, Mathias"
> > <[log in to unmask]>
> > Sent: Wednesday, October 13, 2004 10:16 PM
> > Subject: Re: C-NPU
> >
> >
> > Dear College,
> > With regard to the conversation below I would be happy to
> supply you
> > with
> > whatever information you may need to be conversant with the
> philosophy
> > and
> > practice of the C-NPU that is dedicate to further the cause of
> > metrologically correct and correct transmission the value of
> > quantities (and
> > other properties) that are measured or observed in the clinical
> > laboratory.
> > Yours
> > Urban Forsum
> > Chairman C-NPU
> >
> >
> > Urban Forsum MD, PhD
> > Visiting Professor
> > Department of Pathology and Laboratory Medicine
> > University of Wisconsin
> > cellular phone: +46-708-730157
> > [log in to unmask]
> > private:
> > 34 University Houses
> > Apartment F
> > Madison WI 537 05 USA
> > voice-phone: +1-608-238 2169
> >
> >
> >
> >
> > ----- Original Message -----
> > From: Anders Kallner <[log in to unmask]>
> > Date: Wednesday, October 13, 2004 0:27 am
> > Subject: C-NPU
> >
> >> Dear Urban, Mathias and Jean-Claud,
> >>
> >> The correspondance below appeared on the ACB (Association of
> >> Clinical Biochemists, UK).
> >>
> >> The IFCC/IUPAC and the colleagues in UK in particular should take
> >> this opportunity to contribute with substantial information on the
> >> C-NPU system. It fall upon others to break the insular mind of the
> >> Albions!
> >> Best regards,
> >>
> >> Anders
> >>
> >> How does this sit alongside the obsolescent Read codes and
> >> incipient SNOMED codes ?
> >>
> >> with best wishes
> >>
> >> Richard
> >>
> >> Richard Mainwaring-Burton
> >> Consultant Biochemist
> >> Queen Mary's Hospital
> >> Sidcup, Kent
> >> DA14 6LT
> >> 020-8308-3084
> >>
> >> -----Original Message-----
> >> From: gordon.challand [[log in to unmask]]
> >> Sent: 11 October 2004 13:53
> >> To: [log in to unmask]
> >> Subject: IUPAC/IFCC unique test code numbers
> >>
> >>
> >> I gather that IUPAC and IFCC have developed a list of unique
> >> numerical codes to identify which laboratory test is being carried
> >> out.
> >> Are any UK laboratories using these to identify their own tests;
> >> or are we all using our own self-generated codes for our LISs?
> >> Gordon Challand
> >> ------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 List Archives
> >> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List
> >> Instructions (How to leave etc.) http://www.jiscmail.ac.uk/
> >>
> >>
> >> Anders Kallner
> >> Docent, överläkare
> >> Avd Klin Kemi
> >> Karolinska universitetsjukhuset i Solna
> >> tel 08 5177 49 43
> >> fax 08 517728 99
> >> [log in to unmask]
> >
> > ------ACB discussion List Information--------
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