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ACB-CLIN-CHEM-GEN  2006

ACB-CLIN-CHEM-GEN 2006

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Subject:

Re: Clinical transferability of reports

From:

"Frost, Stephen" <[log in to unmask]>

Reply-To:

Frost, Stephen

Date:

Fri, 8 Sep 2006 10:40:49 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (197 lines)

Hi,

I have found this discussion very informative and with the various
initiatives of the ACB, IFCC, JCTLM and others, perhaps not quite such an
unassailable mountain as first appeared. 

Those who have access to the latest issue of Chemistry World, the RSC
magazine, may be interested in the article by Mike Sargent, Chief Chemical
Metrologist at LGC, entitled 'Made to Measure' (Sep 2006, vol 3, issue 9,
p46). 'The familiar ways of reaching consensus about measurements are
leading chemists into troubled water.' In brief the chemists are looking at
exactly the issues we are and broadly suggesting similar solutions.

Only the abbreviations have changed! For ACB, IFCC and JCTLM read NIST,
REMCO and 'ERM'.

Indeed the aspirations of our chemical colleagues make ours in clinical
biochemistry seem quite modest:
Quote- 'Applying a single scheme of traceable measurements across all areas
of chemistry and biology will achieve the same ambition that brought so many
scientists to Paris in 1875.'

In the short term this duplication of effort of course may be confounding.
For example, whilst we may have the ear of our corporate colleagues in our
field, their company's manufacturing arms will have their ear towards the
chemical committees. There is also the question of who the 'little man in
Whitehall' (or Brussels or Capital Hill) will listening to. However in the
longer term broadly similar concepts of traceability, comparability and
quality assurance are encouraging.

The article includes a table of abbreviations of organisations involved in
standardisation; namely BAM, BCR, BIPM, CIPM, IRMM, ISO, LGC, NIST, REMCO,
UKAS and VAM. Perhaps someone could produce an equivalent table for
abbreviations of Clinical Biochemistry Organisations and committees.

I tend myself to agree there is no magic bullet but that the professions and
other bodies with a will should be able to make significant quick gains on
method comparability, while perhaps there is more steady progress on the
fundamentals. Even if a final solution to traceablity does take another 130
years it will benefit future generations of healthcare professionals. (An
interesting though separate thread would be to guess at the abbreviations of
their titles.)

Regards
Steve

Where there is discord let there be harmony.



[log in to unmask]
Subject: Clinical transferability of reports

 

Ceridwen Coulson wrote:

So,how do we make this happen?

 

A quick brain dump:

1 Recognise that it is important, and that it may require lots of local
changes, including methods, platforms, handbooks and reference intervals.

 

2 Require it in procurement. 

 

3 Lots of work on harmonisation along the lines that Bart Ballieux has
described. 

 

4 Identify and deliver some early winners.

 

5 Find a professional route for addressing the relevant analytical and
metrological issues, including those that Jonathan Middle and and Roger
Ekins have identified in this mailgroup. This will be difficult when there
are clashes between eg analytical traceability and clinical transferability.


 

6 End the confusion between the two meanings of test: test = assay and test
= a procedure that adds clinical information. 

 

Jonathan

 

On 1 Sep 2006, at 13:20, Ceridwen Coulson wrote:





So,how do we make this happen? What are the blocks and impediments in the
way? Where method differences preclude common reference intervals can't we
devise some way of getting around the situation?

Julian Barth is following this up with ACB,but,I agree with James,it's
slow.Is the ACB the only professional body interested?

Ceridwen

-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Jonathan Kay
Sent: 01 September 2006 12:36
To: [log in to unmask]
Subject: Clinical transferability of reports

I was about to reply along exactly the same lines as James. (But I would
describe what we need as "clinical transferability" rather than "common
reference intervals".) 

 

This lack of transferability impedes attempts at knowledge management for
laboratory medicine, as well as the development of computerised patient
records. It's probably also clinically dangerous.

 

See also the previous debate about glycated haemoglobin.

 

The irony of course is that for domains where text is the output (eg
radiology reports) the problem is less acute, as clinicians always have to
try to understand what is in the report, and know that eg different
radiologists report differently. (And that intentionally says "acute" and
not "serious".)

 

Jonathan

 

 

 







  _____  

size=2 width="100%" align=center> 

From: Hooper James 
Sent: 01 September 2006 12:24
To: 'Hullin Dave'
Subject: RE: LDH

Yet another reason for having national reference intervals! We shoot
ourselves in the foot as far as governmental agencies are concerned. Here we
are, probably the most computer-conscious discipline within medicine,
supporting the electronic health record (available anywhere nationally) and
we can't even agree common reference intervals! We don't need endless
debates about minor method differences - it's the outcome that matters. We
need to move quickly for credibility's sake.

James Hooper


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