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Interpreting changes in consecutive laboratory results: clinician's perspectives on clinically significant change
Soo-Kyung Kim1, Jae-Woo Chung2, Jinsook Lim3
1Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
Summary
Clinicians often overestimate clinically significant changes in lab tests compared to the reference change value (RCV). Understanding test variability is crucial for accurate patient assessment.
Area of Science:
- Clinical Chemistry
- Laboratory Medicine
- Medical Diagnostics
Background:
- Clinical laboratory tests are subject to various influencing factors.
- Interpreting consecutive test results requires accounting for inherent test uncertainty.
- Reference Change Value (RCV) is used by labs to define significant changes, but clinician interpretation criteria are unclear.
Purpose of the Study:
- To investigate how clinicians interpret clinically significant changes in consecutive laboratory test results.
- To compare clinicians' interpretations with established Reference Change Values (RCV).
Main Methods:
- A questionnaire survey was distributed to clinicians.
- Clinicians evaluated 22 laboratory test items across two scenarios to identify significant changes.
- Reference Change Values (RCV) for analytes were sourced from the EFLM database.
Main Results:
- 290 valid responses were analyzed.
- Clinicians showed inconsistency in identifying significant changes, with interpretations generally exceeding RCV.
- Clinicians reported unfamiliarity with laboratory test variability.
Conclusions:
- Clinicians' perceived significant changes often surpassed RCV, indicating a potential overestimation.
- Clinicians tended to overlook analytical and biological variations in laboratory tests.
- Laboratories should educate clinicians on RCV to improve patient management decisions.
Keywords:
Biological variationClinically significant changeConsecutive laboratory resultReference change valueMore Related Videos
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