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Reflective testing: how useful is the practice of adding on tests by laboratory clinicians?
1Area Biochemistry Department, Dumfries and Galloway Royal Infirmary, Bankend Road, Dumfries DG1 4AP, UK. J.Paterson@dgri.scot.nhs.uk
Journal of Clinical Pathology
|March 3, 2004
Summary
Reflective testing, the addition of new lab tests based on clinical judgment, successfully identified patients with haemochromatosis and vitamin D deficiency. This practice aids in diagnosing complex conditions during result reporting.
Area of Science:
- Clinical Biochemistry
- Laboratory Medicine
- Diagnostic Testing
Background:
- Reflective testing, or adding tests during result reporting, is a clinical practice.
- This practice relies on the laboratory clinician's interpretation of initial results and patient data.
Purpose of the Study:
- To evaluate the clinical utility of reflective testing.
- To introduce and define the term 'reflective testing' for this practice.
Main Methods:
- A consultant medical biochemist collected data on added iron studies and vitamin D tests over one year.
- Tests were added based on biochemical results, clinical information, and clinical experience suggesting potential haemochromatosis or vitamin D deficiency.
Main Results:
- Reflective testing identified 28 patients with elevated TIBC saturation (18.7%), with 8 confirmed for haemochromatosis.
- Thirty-one patients (23.1%) were diagnosed with vitamin D deficiency through added testing.
Conclusions:
- Reflective testing by laboratory clinicians effectively identifies patients with haemochromatosis and vitamin D deficiency.
- The term 'reflective testing' accurately describes this discretionary, clinically-judged practice.
