HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Laposata, M. Search for Related Content PubMed PubMed Citation Articles by Laposata, M. Related Collections Molecular Diagnostics and Genetics Laboratory Management Clinical Immunology Evidence Based Laboratory Medicine and Test Utilization Hemostasis and Thrombosis Proteomics and Protein Markers Lipids, Lipoproteins, and Cardiovascular Risk Factors Drug Monitoring and Toxicology Hematology Endocrinology and Metabolism

Patient-specific Narrative Interpretations of Complex Clinical Laboratory Evaluations: Who Is Competent to Provide Them?

¹ Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, Fax 617-726-3256, E-mail mlaposata@partners.org

The first 20% of the full text of this article appears below.

The report To Err Is Human, by the Institute of Medicine (1), has sparked much interest in establishing clinical error rates. The data in the report are focused primarily on medication errors, anesthesia errors, and other procedural errors. Errors associated with establishing the diagnosis, however, received little consideration. One reason is that diagnoses are often established by laboratory test results, and it is difficult to identify errors in test selection and misinterpretation of test results. There is now a spoken need for a change in the current system to provide physicians with assistance in selection of the correct assays and to provide patient-specific interpretations of complex test results to make a clinical decision (2)(3)(4).

The report by Lim et al. (5) in this issue of the Journal describes a quality assessment of interpretive commenting in clinical chemistry. Previous reports have described the interpretive process and noted the value of the service (6)(7)(8), but this study evaluates the performance of potential interpreters for the service process. The interpretations in the study by Lim et al. (5) were generated by pathologists or senior scientists and "any other interested laboratory personnel". The data in this report demonstrate the need for highly knowledgeable individuals, most likely within individual subspecialties of clinical chemistry (e.g., toxicology, endocrinology, and tumor markers), to interpret complex clinical laboratory evaluations. The authors found (as judged by a panel of . . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				G. Eisenhofer, J. W.M. Lenders, D. S. Goldstein, M. Mannelli, G. Csako, M. M. Walther, F. M. Brouwers, and K. Pacak Pheochromocytoma Catecholamine Phenotypes and Prediction of Tumor Size and Location by Use of Plasma Free Metanephrines Clin. Chem., April 1, 2005; 51(4): 735 - 744. [Abstract] [Full Text] [PDF]

eLetters: