解释实验室测试的正常值和参考范围
Nancy Doles1, May Ye Mon1, Arika Shaikh1
1From the Department of Family Medicine (ND, AS, SM, DP, DS); Department of Pathology, Medical College of Georgia at Augusta University, GA (MYM).
Journal of the American Board of Family Medicine : JABFM
|April 23, 2025
概括
实验室测试结果会影响临床决策,但正常范围可能会引起患者焦虑. 了解变异和临床意义是医生与患者之间关于健康评估的有效沟通的关键.
科学领域:
- 临床病理学 临床病理学
- 医学诊断 医学诊断 医学诊断
- 卫生沟通健康沟通
背景情况:
- 实验室测试结果对于大约70%的临床决策至关重要,包括诊断,预后和疾病监测.
- 患者直接获取实验室结果已经显著改变了医生与患者的互动.
- 与正常实验室值的轻微偏差可能会导致患者过度焦虑.
研究的目的:
- 审查影响实验室测试结果及其解释的因素.
- 解决医生和患者对实验室发现的评估和报告的担忧.
- 探索改善向患者传达实验室结果的方法.
主要方法:
- 文献审查检查影响实验室测试结果的因素.
- 分析建立参考范围的统计基础 (例如95%方法).
- 讨论测试方法的变化,人口统计和固有的生物变异性.
主要成果:
- 建立正常范围的标准方法 (95%的健康人群) 本质上将5%的健康人群标记为异常.
- 测试方法的变化,患者人口统计学 (年龄,性别,种族) 和季节性都会导致结果的变化.
- 临床上没有意义的异常结果往往超过那些具有真正临床意义的异常结果.
结论:
- 实验室结果的清晰沟通,包括简单的临床意义,是必不可少的.
- 提供超越数字值的背景,可以减轻患者的焦虑和提高理解.
- 将解释性指导与实验室报告相结合,可以加强患者与医生的对话和共同决策.
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