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Related Experiment Videos

Problems in interpreting laboratory tests. What do unexpected results mean?

M L Brigden1, J C Heathcote

  • 1Penticton Regional Hospital, BC, Canada. mbrigden@oshr.org

Postgraduate Medicine
|July 11, 2000
PubMed
Summary

Physicians should understand that differing lab test results are often due to natural biologic variation, not errors. Awareness of intraindividual variation and age-related changes is crucial for accurate geriatric patient assessment.

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Area of Science:

  • Clinical Chemistry
  • Geriatric Medicine
  • Laboratory Medicine

Background:

  • Physicians must avoid overreacting to abnormal laboratory values, which can lead to unnecessary investigations or treatments.
  • Understanding the causes of discrepant laboratory test results is essential for accurate patient assessment.

Observation:

  • Intraindividual biologic variation is a more common cause of differing test results than laboratory error or clinical status changes.
  • Age-associated physiologic changes can alter laboratory values in the elderly, mimicking pathology.

Findings:

  • Specific laboratory tests with significant intraindividual variation include serum alkaline phosphatase, fasting blood glucose, and hemoglobin.
  • In healthy elderly individuals, certain values like fasting blood glucose and erythrocyte sedimentation rate may appear abnormal without pathology.

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  • A normal serum creatinine level can be misleading in the elderly if creatinine clearance is markedly decreased.

    • Implications:

    • Clinicians need to be aware of age-related laboratory value changes to properly assess geriatric patients.
    • Establishing age-specific reference ranges, particularly for those over 75, requires further clinical research.
    • Recognizing biologic variation prevents unnecessary medical interventions and improves diagnostic accuracy in the elderly.