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ABSTRACT: Within the UK there has been a rapid move to include the reporting of estimated glomerular filtration rate (eGFR) values to identify patients with chronic kidney disease (CKD). Guidance has also changed since its original introduction. This national audit aimed to establish how eGFR is reported by laboratories within the UK.
A questionnaire was sent to 164 UK National Health Service laboratories, which included questions on the patient groups who had eGFR reported, the eGFR thresholds used, adjustments made for ethnicity and the means of identifying proteinuria. The audit standards used were based on the 2008 National Institute for Health and Clinical Excellencec (NICE) CKD guidance.
One hundred and thirty-one of the 164 laboratories (80%) responded. Forty-six percent reported eGFR on all adult requests while 36% limited use to general practitioners. Twenty-one percent did not issue eGFR to any inpatient. Sixty-two percent and 30% of laboratories had an upper reporting limit of ≥90 and ≥60 mL/min/1.73 m(2), respectively; the remainder having higher thresholds. Sixty percent cited an ethnicity 'correction factor' on the report, 59% in a guideline but 28% in neither. An albumin:creatinine ratio was used by 63% to detect non-diabetic proteinuria, while 37% exclusively used a protein:creatinine ratio.
There has been rapid implementation of eGFR reporting in the UK since 2006. However, there is considerable variation in the way it is reported, with few laboratories currently exactly matching existing NICE recommendations. A reassessment of biochemical CKD assessment by most laboratories following a reiteration and clarification of current recommendations seems warranted.
Annals of Clinical Biochemistry 09/2011; 48(Pt 6):558-61. · 2.17 Impact Factor
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ABSTRACT: There is still debate as to whether the addition of interpretative comments to laboratory reports can influence the management of patients. Little is known about the extent of this activity in individual laboratories throughout the UK and so this national survey aimed to establish the prevalence.
An electronic questionnaire was sent to 196 NHS laboratories in the UK asking whether 17 commonly requested groups of tests were reported with interpretative comments and, if so, how laboratory computers and/or humans were involved in the process. Enquiries were also made of the grades of staff performing the process and of any 'vignette' examples where interpretative reporting had improved the clinical outcome for the patient.
A total of 138 of the 196 laboratories (70%) responded. Only two laboratories did not have staff adding interpretative comments to any of the 17 tests. Consultant laboratory staff reporting predominated in all tests with a significant minority also being added by biomedical scientists. High-volume requests usually had staff adding comments to results selected by computer rules whereas more of the specialist endocrine tests tended to be considered for comment. Only six of 71 vignettes referred specifically to 'routine' biochemistry.
The addition of interpretative comments onto clinical biochemistry reports is widespread throughout the UK. This service is largely consultant led. There is anecdotal evidence that the process can influence the clinical management of patients.
Annals of Clinical Biochemistry 06/2011; 48(Pt 4):317-20. · 2.17 Impact Factor
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Eric S Kilpatrick
Annals of Clinical Biochemistry 02/2009; 46(Pt 1):84-5. · 2.17 Impact Factor
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Eric S Kilpatrick
Annals of Clinical Biochemistry 02/2009; 46(Pt 1):86. · 2.17 Impact Factor
