The thymol turbidity test and determination of serum cholesterol : two tests to abandon in the routine evaluation of...

The thymol turbidity test (Macglan's test) and the determination of serum cholesterol are still performed routinely as liver function tests in many laboratories. In this report, we have employed quantitative methods in order to evaluate the real usefulness of these two parameters. In a first step, the value of the thymol test and of cholesterol determination for the discrimination of the 13 most frequent hepato-biliary diseases was studied by analysis of variance, and compared to that of the following tests : serum bilirubin, serum glutamic pyruvic transaminase, serum alkaline phosphatase serum protein electrophoresis and prothrombin time. It was found that of all these parameters, the thymol test and cholesterol measurement had the lowest discriminatory powers. In a second step, the consequences of the suppression of the two tests were examined by linear discrimination analysis, which was done for all the possible pairs of diseases. It appeared that in each case, the loss of information due to the elimination of the thymol test or of cholesterol determination was nil or negligible. We conclude therefore that the thymol turbidity test and determination of serum cholesterol should be abandoned as routine tests of liver function.