Interpretive Lab Results
As physicians are inundated more and more by tons of data it has become more important to help them interpret lab data. I personally think of this not as a chore but as a wonderful opportunity to demonstrate our expertise.
We already do that to some degree now. If you think about it, shouldn't a physician know the reference interval for a glucose? Then do we include it on a report? OK, so there are different methods and the doctors may practice at different sites or use different labs, but we still don't just give them a reference guide or a cover sheet. We include the reference interval next to every result we report.
Many times the result is further flagged if it is abnormal in some way (listed as high, low, positive, negative or bolded).This is not simply as a courtesy to the physician; it also helps to ensure patient safety. We don't want a physician guessing or treating a patient inappropriately based on a misinterpreting the significance of a lab result.
Should we be doing even more for ,say, for troponin: what level is indicative of ischemia and what level is "negative"? Should we decide that a repeat test is not indicated or that a delta value is not significant? Should we suggest appropriate tests based on initial testing?Should we limit some tests to one per hospital stay, autocancel duplicates and offer a canned report explaining why?
With information technology what it is these days, such interpretation is very easy to do. There is also lots of data and research to support cut-points, reference intervals and tests which are more useful than others.
Pathologists do that sort of interpretation all the time; but that is widely accepted without debate because it is physician-to-physician communication.
Reports, at least anecdotally, are that physicians for the most part welcome interpretive reporting and base clinical decisions on the laboratory's interpretation of a result. It seems that this is one area in which clinical laboratorians could use their unique expertise to help clinicians and patients, showcase their knowledge and create goodwill and enhance their reputation at the same time.