Are there any [evidence-based] advocates for P to L within UK??
If not, it's "easy" isn't it - along lines of salicylate and paracetamol units, equimolar PSA assays - changes, all of which Panel along with EQA providers and other colleagues have brought about.
[has been raised in relation to MAPS as well]
dj
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Bullock
Sent: 10 September 2012 20:32
To: [log in to unmask]
Subject: Lactate Dehydrogenase comparability
Martin:
I'm gratified by your personal support for my advocacy for adoption of a single method principle across the UK, to facilitate comparability of all results submitted to the EPR and other cumulative patient records. This was included in our report to CfH/DH on the validity of combining data (accessable through birminghamquality.org.uk - this demonstrates how UK NEQAS experience can inform national practice), but had to be classified as a responsibility of professional societies
Unfortunately, there appears to be no clear route to get such recommendations forcibly to the attention of DH/CfH/NLMC/etc with a view to national implementation, despite what I believe to be substantive patient safety issues:
- can responsible individuals (eg Paul, Gifford & Ian) take this forward themselves in their designated professional roles?
- do the ACB Scientific Committe or Clinical Practice Division have a formal input route?
- what can the National Quality Assurance Advisory Panel and Joint Working Group (ie Pat, Tim & David) do through RCPath? I'm fairly sure Archie Prentice would facilitate such communications in the interests of national comparability of patient care
- can BIVDA (though Doris-Ann) confirm that all members have reagents available that comply, and if not what can be done to resolve the situation?
- has Pathology Harmony (over to you, Jonathan!) ever considered this issue? If PH can firmly advocate the minority practice of reporting haemoglobin in g/L, why not adoption of a two-thirds or even one-third practice (UK NEQAS can provide you with evidence on the national picture) for enzyme activity assays?
To be fully effective, this must be a collaborative effort - and similar issues also arise for PyrP inclusion in AST/ALT assays and buffer selection in ALP assay. We have a collective professional responsibility to resolve these essentially arbitrary choices
Best wishes, and no apologies whatsoever for being provocative
David
Organiser, UK NEQAS for Clinical Chemistry and Director, Birmingham Quality
PS1: If I was feeling jaundiced, I'd suggest UK NEQAS could have driven these initiatives 20 years ago if only Margaret Thatcher hadn't intervened with the mantra of "competition, even at the expense of comparability" . . .
PS2: [with tongue very firmly in cheek] Remembering my classical chemistry education, perhaps we could best enlist SoS support by expressing all recommendations as being valid "at ultimate dilution" . . .
________________________________
From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Myers Martin (LTHTR) [[log in to unmask]]
Sent: 10 September 2012 18:59
To: [log in to unmask]
Subject: Re: Lactate Dehydrogenase
the counts are in!
There is an IFCC "reference" method: L to P The best LDH method as a tumour marker is L to P (Tietz and others).
I agree with David Bullock we should use just one method It would appear that L to P is the method of choice and for patient safety reasons we should all use L to P.
martin
________________________________
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Myers Martin (LTHTR)
Sent: 05 September 2012 11:36
Do people have a view on whether lactate dehydrogenase should be measured by lactate to pyruvate or pyruvate to lactate, especially if the LDH assay is primarily being used as a tumour marker?
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------ACB discussion List Information--------
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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.
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