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How physicians use laboratory tests.

L P Skendzel

    JAMA
    |March 13, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Physicians

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    Area of Science:

    • Clinical Pathology
    • Medical Decision Making

    Background:

    • Physician interpretation of laboratory results is crucial for patient care.
    • Understanding the threshold for clinically significant changes in lab values informs diagnostic and treatment decisions.

    Purpose of the Study:

    • To quantify physician-perceived clinically important changes in common laboratory test results.
    • To compare these perceptions with laboratory precision standards.

    Main Methods:

    • 125 internists reviewed clinical scenarios and indicated critical changes in lab values.
    • Responses were analyzed to determine the most frequently cited significant changes for various analytes.
    • Physician-perceived changes were compared against national quality control data for laboratory precision.

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    Main Results:

    • Specific clinically important change thresholds were identified for glucose, BUN, sodium, potassium, uric acid, creatinine, calcium, triglycerides, hemoglobin, and osmolality.
    • Laboratory testing quality was deemed satisfactory for clinical use in 80% of assessed settings.
    • Significant variation exists in physician thresholds for interpreting lab result changes.

    Conclusions:

    • Establishing consensus on clinically important laboratory value changes is essential.
    • Correlating laboratory performance with clinical application of results improves patient care.
    • Physician perception of laboratory result significance varies widely, highlighting a need for standardized interpretation guidelines.