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ACB-CLIN-CHEM-GEN  October 2008

ACB-CLIN-CHEM-GEN October 2008

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Subject:

Re: An interesting comparison...

From:

Horváth Andrea <[log in to unmask]>

Reply-To:

Horváth Andrea <[log in to unmask]>

Date:

Wed, 8 Oct 2008 12:06:08 +0200

Content-Type:

text/plain

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text/plain (188 lines)

Ian, so the key to make ourselves more useful for clinical colleagues is 
that we do not teach them about clin biochem at med school, i.e. keep 
them in the dark about lab med? Ok, I am just sarcastic...:-)))

Otherwise, I fully agree with what you all say below. In Hungarian 
language we even have different words for distinction of lab results 
(more or less printouts of a battery of results) from lab reports which 
contain interpretive comments about the lab findings. Unfortunatly, most 
clinicians think, however, that obtaining a lab result is just easy, as 
you push your sample in at one end and the correct result comes out at 
the other end of your analyzer without any further input from lab staff. 
Clearly they have no idea about the Qc and method validation and report 
authorization efforts that we are so busy with otherwise. So commenting 
and consultation, or ward visits and clinical work by lab staff are 
essential for raising the profile of our profession.

Having worked in the UK, I know very well, that lab professionals in the 
UK do far more commenting and consultation and even look after patients 
in outpatient clinics, which is not the norm in most European countries. 
So keep up with the good clinical work, you are in an exceptionally good 
position in that respect, so preserve it!!

Kind regards, Rita Horvath (Hungary)


Ian Barlow írta:
> Over the past few days/weeks we have seen the debate about the lack of 
> Clinical Biochemistry/Pathology teaching in the Medical curriculum 
> (certainly in the UK).
> In my experience, and I suspect as a direct result of this,  I am 
> called upon daily to provide more and more interpretative input 
> into our end product (irrespective whether the results are from 
> automated chemistry/endocrinology/specific proteins etc etc) therefore 
> a radiology report  * clearly is * analogous to the print out of a 
> biochemistry analyser if it is accompanied by an opinion/advisory 
> comment.
>  
> Best wishes
>  
> Ian
>
>     -----Original Message-----
>     *From:* Clinical biochemistry discussion list
>     [mailto:[log in to unmask]]*On Behalf Of *Elizabeth
>     MacNamara
>     *Sent:* 06 October 2008 21:13
>     *To:* [log in to unmask]
>     *Subject:* Re: An interesting comparison...
>
>     I am sorry Francis I can not agree with you and I can see you have
>     never been in my laboratory or have any understanding of the way I
>     or my staff work. I probably to twice the amount of QC and
>     validation you do in your laboratory, I ensure everything is
>     checked by more than one methodHowever, if an analyser produces
>     14,000 results a day it is not the same as a radiologist reading
>     CT, MRI or XRays. It is is also not the same as us reading an
>     immunofixation or a complex AA, GC_MS, LC-MS etc, result. Our work
>     is very important but we do not have to pretend that automated
>     chemistry results are the same as tests requiring interpretation
>     be they from our laboratory or radiology, they are not.
>
>     Elizabeth
>
>     Frances Rosenberg wrote:
>>     Wake up and smell the roses!
>>     Do you installed a chemistry analyzer and rely solely on the
>>     manufacturer supplied information to provide reference
>>     information (a process for which the manufacturer undoubtedly
>>     issues a disclaimer)? If that is your usual practice, then I
>>     agree there is a difference between your laboratory report for
>>     core biochemistry and a radiology report.
>>     However, if a member of your professional staff (versus
>>     your reliance on the manufacturer) takes responsibility for the
>>     information conveyed by the test report (which may extend beyond
>>     RIs and include standard interpretive comments) then the
>>     distinction between radiology and biochemistry becomes blurred.
>>     This is the situation where I practice. We scrutinize
>>     manufacturer supplied information and pursue various avenues to
>>     validate/replace/supplement that information.  
>>     It may be that your response reflects how you practive laboratory
>>     medicine or you may not have reflected sufficiently on the issue. 
>>      
>>     Frances Rosenberg MD PhD FRCP(C)       
>>     Medical Biochemist      
>>     Pathology and Laboratory Medicine
>>     St. Paul's Hospital Vancouver BC V6Z 1Y6
>>     Phone (604) 806-8190 Fax (604) 806-8158
>>
>>         -----Original Message-----
>>         *From:* Clinical biochemistry discussion list
>>         [mailto:[log in to unmask]]*On Behalf Of
>>         *Elizabeth Mac Namara
>>         *Sent:* Friday, September 05, 2008 8:19 AM
>>         *To:* [log in to unmask]
>>         <mailto:[log in to unmask]>
>>         *Subject:* Re: An interesting comparison...
>>
>>         I completely agree with the statement: A radiology report is
>>         an interpretation and the result from a biochemistry analyser
>>         is not. A protein electrophoresis and immunofixation report
>>         is an interpretation and neither is it analogous to a
>>         printout of a biochemistry analyser. I do not see giving a
>>         biochemistry results to someone the same as discussing them
>>         with them. I am not quite sure people are so upset.
>>
>>         Elizabeth Mac Namara
>>         Jewish General Hospital
>>         Montreal
>>>         Date: Fri, 5 Sep 2008 08:32:28 +0100
>>>         From: [log in to unmask]
>>>         <mailto:[log in to unmask]>
>>>         Subject: An interesting comparison...
>>>         To: [log in to unmask]
>>>         <mailto:[log in to unmask]>
>>>
>>>         http://www.bmj.com/cgi/content/full/337/aug11_1/a785
>>>
>>>
>>>          "A radiology^  report is much more than simply the result
>>>         of a test. It is not analogous to the print out of a
>>>         biochemistry analyser but^  should be a fully informed
>>>         clinical decision" 
>>>
>>>
>>>         Jonathan
>>>         ------ACB discussion List Information-------- This is an
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>>>         <http://get.live.com/en-ca/mailplus/features>------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
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>>>         Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ 
>>         ------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/ 
>>
>
>     ------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/ 
>
> ------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/ 

------ACB discussion List Information--------
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