scholarly journals Reminders of Drug Effects on Laboratory Test Results

2000 ◽  
Vol 46 (9) ◽  
pp. 1395-1400 ◽  
Author(s):  
Marita Kailajärvi ◽  
Timo Takala ◽  
Paula Grönroos ◽  
Nils Tryding ◽  
Jorma Viikari ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Drug Effects ◽  
Study Drug ◽  
Test Results ◽  
Potential Drug ◽  
Reminder System ◽  
Patient Medication ◽  
Laboratory Test Results ◽  
Laboratory Results

Abstract Drug effects on laboratory test results are difficult to take into account without an online decision support system. In this study, drug effects on hormone test results were coded using a drug-laboratory effect (DLE) code. The criteria that trigger the reminders were defined. To issue reminders, it was necessary to write a computer program linking the DLE knowledge base with databases containing individual patient medication and laboratory test results. During the first 10 months, 11% of the results from hormone samples were accompanied by one or more DLE reminders. The most common drugs to trigger reminders were glucocorticoids, furosemide, and metoclopramide. Physicians facing the reminders completed a questionnaire on the usefulness of the reminders. All respondents considered them useful. In addition, DLE reminders had caused 74% of respondents to refrain from additional, usually performed examinations. In conclusion, drug effects on laboratory tests should always be considered when interpreting laboratory results. An online reminder system is useful in displaying potential drug effects alongside test results.

scholarly journals Utilisation of laboratory test results for patient management by clinicians at two large referral hospitals in Zambia

2020 ◽  
Author(s):  
Sabe Mwape ◽  
Victor Daka ◽  
Scott Matafwali ◽  
Kapambwe Mwape ◽  
Jay Sikalima ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
Medical Laboratory ◽  
Test Results ◽  
Cross Sectional ◽  
Childrens Hospital ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Referral Hospitals

Background Medical laboratory diagnosis is a critical component of patient management in the healthcare setup. Despite the availability of laboratory tests, clinicians may not utilise them to make clinical decisions. We investigated utilsation of laboratory tests for patient management among clinicians at Ndola Teaching Hospital (NTH) and Arthur Davison Childrens Hospital (ADCH), two large referral hospitals in the Copperbelt Province, Ndola, Zambia. Method We conducted a descriptive cross-sectional study among clinicians. The study deployed self-administered questionnaires to evaluate clinician utilisation, querying and confidence in laboratory results. Additional data on demographics and possible laboratory improvements were also obtained. Data were entered in Microsoft excel and exported to SPSS version 16 for statistical analysis. Results Of the 80 clinicians interviewed, 96.2% (77) reported using laboratory tests and their results in patient management. 77.5% (62) of the clinicians indicated they always used laboratory results to influence their patient management decisions. Of the selected laboratory tests, clinicians were more confident in using haemoglobin test results (91.2%). There was no statistically significant association between the clinicians gender or qualification and use of test results in patient management. Conclusion Our findings show that despite the majority querying laboratory results, most of the clinicians use laboratory results for patient management. There is need for interactions between the laboratory and clinical area to assure clinician confidence in laboratory results. Key words: utilisation, clinicians, laboratory tests, Ndola Teaching Hospital, Arthur Davison Childrens Hospital

Herbal Remedies: Effects on Clinical Laboratory Tests

2006 ◽  
Vol 130 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Amitava Dasgupta ◽  
David W. Bernard
Keyword(s):  
Chinese Medicine ◽  
Laboratory Test ◽  
Alternative Medicine ◽  
Clinical Laboratory ◽  
Herbal Remedies ◽  
Test Results ◽  
Abnormal Laboratory ◽  
St John's Wort ◽  
Laboratory Test Results ◽  
Laboratory Results

AbstractContext.—Complementary and alternative medicine (herbal medicines) can affect laboratory test results by several mechanisms.Objective.—In this review, published reports on effects of herbal remedies on abnormal laboratory test results are summarized and commented on.Data Sources.—All published reports between 1980 and 2005 with the key words herbal remedies or alternative medicine and clinical laboratory test, clinical chemistry test, or drug-herb interaction were searched through Medline. The authors' own publications were also included. Important results were then synthesized.Data Synthesis.—Falsely elevated or falsely lowered digoxin levels may be encountered in a patient taking digoxin and the Chinese medicine Chan Su or Dan Shen, owing to direct interference of a component of Chinese medicine with the antibody used in an immunoassay. St John's wort, a popular herbal antidepressant, increases clearance of many drugs, and abnormally low cyclosporine, digoxin, theophylline, or protease inhibitor concentrations may be observed in a patient taking any of these drugs in combination with St John's wort. Abnormal laboratory results may also be encountered owing to altered pathophysiology. Kava-kava, chaparral, and germander cause liver toxicity, and elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin concentrations may be observed in a healthy individual taking such herbal products. An herbal product may be contaminated with a Western drug, and an unexpected drug level (such as phenytoin in a patient who never took phenytoin but took a Chinese herb) may confuse the laboratory staff and the clinician.Conclusions.—Use of alternative medicines may significantly alter laboratory results, and communication among pathologists, clinical laboratory scientists, and physicians providing care to the patient is important in interpreting these results.

scholarly journals Unit conversions between LOINC codes

2017 ◽  
Vol 25 (2) ◽  
pp. 192-196 ◽  
Author(s):  
Ronald G Hauser ◽  
Douglas B Quine ◽  
Alex Ryder ◽  
Sheldon Campbell
Keyword(s):  
Laboratory Test ◽  
Data Aggregation ◽  
Controlled Vocabulary ◽  
Test Results ◽  
Computational Process ◽  
Clinical Tests ◽  
Laboratory Test Results ◽  
Immunodeficiency Virus ◽  
Laboratory Results ◽  
Sodium Magnesium

Abstract Logical Observation Identifiers Names and Codes (LOINC) is the most widely used controlled vocabulary to identify laboratory tests. A given laboratory test can often be reported in more than 1 unit of measure (eg, grams or moles), and LOINC defines unique codes for each unit. Consequently, an identical laboratory test performed by 2 different clinical laboratories may have different LOINC codes. The absence of unit conversions between compatible LOINC codes impedes data aggregation and analysis of laboratory results. To develop such conversions, a computational process was developed to review the LOINC standard for potential conversions, and multiple expert reviewers oversaw and finalized the conversion list. In all, 285 bidirectional conversions were identified, including conversions for routine clinical tests such as sodium, magnesium, and human immunodeficiency virus (HIV). Unit conversions were applied to the aggregation of laboratory test results to demonstrate their usefulness. Diverse informatics projects may benefit from the ability to interconvert compatible results.

Reduction of Laboratory Utilization in the Intensive Care Unit

2016 ◽  
Vol 32 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Samih Raad ◽  
Rachel Elliott ◽  
Evan Dickerson ◽  
Babar Khan ◽  
Khalil Diab
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Routine Laboratory ◽  
Test Results ◽  
Staff Education ◽  
Arterial Blood ◽  
Laboratory Test Results ◽  
Order Sets

Objective: In our academic intensive care unit (ICU), there is excess ordering of routine laboratory tests. This is partially due to a lack of transparency of laboratory-processing costs and to the admission order plans that favor daily laboratory test orders. We hypothesized that a program that involves physician and staff education and alters the current ICU order sets will lead to a sustained decrease in routine laboratory test ordering. Design: Prospective cohort study. Setting: Academic closed medical ICU (MICU). Patients: All patients admitted to the MICU. Methods: We consistently educated residents, faculty, and staff about laboratory test costs. We removed the daily laboratory test option from the admission order sets and asked residents to order needed laboratory test results every day. We only allowed the G3+I-STAT (arterial blood gas only) cartridges in the MICU in hopes of decreasing duplicative laboratory test results. We added laboratory review to the daily rounding checklist. Measurement and Main Results: Total number of laboratory tests per patient-day decreased from 39.43 to an average of 26.74 ( P <.001) over a 9-month period. The number of iSTAT laboratory tests per patient-day decreased from 7.37 to an average of 1.16 ( P < .001) over the same time period. The number of iSTAT/central laboratory processing duplicative laboratory tests per patient-day decreased from 0.17 to an average of 0.01 ( P < .001). The percentage of patients who have daily laboratory test orders decreased from 100% to an average of 11.94% ( P <. 001). US$123 436 in direct savings and US$258 035 dollars in indirect savings could be achieved with these trends. Intensive care unit morbidity and mortality were not impacted. Conclusion: A simple technique of resident, nursing, and ancillary staff education, combined with alterations in order sets using electronic medical records, can lead to a sustained reduction in laboratory test utilization over time and to significant cost savings without affecting patient safety.

scholarly journals Association of Test Results for 33 Frequently Used Laboratory Tests with Body Mass Index (BMI)

2020 ◽  
pp. 1-4
Author(s):  
Anders Larsson ◽  
Anders Larsson ◽  
Johan Ärnlöv ◽  
Johanna Helmersson-Karlqvist ◽  
Lars Lind ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Laboratory Test ◽  
Body Mass ◽  
Cystatin C ◽  
Apolipoprotein B ◽  
Laboratory Tests ◽  
Hdl Cholesterol ◽  
Apolipoprotein A1 ◽  
Test Results ◽  
Laboratory Test Results

Once considered a problem only for high-income countries, obesity rates are now rising worldwide. When evaluating test results from obese patients it is important to be aware of the effect of obesity on individual laboratory test results. The aim of the present study was to study the association between body mass index (BMI) and a group of frequently requested laboratory tests to evaluate which of these analytes that are affected by BMI. We analyzed the association between body mass index (BMI) and Alanine aminotransaminase (ALT), Albumin, Alkaline phosphatase, Pancreatic amylase, Apolipoprotein A1, Apolipoprotein B, Apolipoprotein B/Apolipoprotein A1 ratio, Aspartate aminotransferase (AST), AST/ALT ratio, Bilirubin, Calcium, Calprotectin, Cholesterol, HDL-cholesterol, Creatinine kinase (CK), Creatinine, C-reactive protein, Cystatin C, Gamma-glutamyl transferase (GGT), Iron, Iron saturation, Lactate dehydrogenase (LDH), Magnesium, Phosphate, Transferrin, Triglycerides, Urate, Urea, Zink, Hemoglobin, Platelet count and White blood cell count in an 80-year old population (n=531, 266 females and 265 males). There were significant Spearman rank associations between BMI and laboratory test results for several of the studied markers in both females and males. The strongest associations with BMI were noted for ALT, Apolipoprotein A1, HDL-cholesterol, Hemoglobin, CRP, Cystatin C, Triglycerides and Urate. In conclusion, several of the most frequently used laboratory markers are significantly associated with BMI. To be able to correctly interpret a test result it is important to be aware of the effects of BMI on the test results.

Perturbation of laboratory test results by analytical interferences and drug effects

Talanta ◽  
1984 ◽  
Vol 31 (10) ◽  
pp. 937-941
Author(s):  
M.M. Galteau ◽  
G. Siest
Keyword(s):  
Laboratory Test ◽  
Drug Effects ◽  
Test Results ◽  
Laboratory Test Results

The Usefulness of Laboratory Tests in Health-Screening Programs

1973 ◽  
Vol 19 (4) ◽  
pp. 366-372 ◽  
Author(s):  
David L Sackett
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Health Screening ◽  
Test Results ◽  
Screening Programs ◽  
Laboratory Screening ◽  
Rare Exception ◽  
Laboratory Test Results ◽  
The Mean ◽  
Regression Toward The Mean

Abstract I discuss pitfalls in laboratory-screening programs: regression toward the mean on repeated biochemical determinations; the problem of defining normalcy in the interpretation of laboratory test results; and a remarkable professional myopia in which clinical chemists have, with rare exception, failed to accept responsibility for evaluating whether the programs in which they are engaged are of benefit to patients.

scholarly journals Patient Challenges and Needs in Comprehending Laboratory Test Results: Mixed Methods Study

10.2196/18725 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e18725
Author(s):  
Zhan Zhang ◽  
Daniel Citardi ◽  
Aiwen Xing ◽  
Xiao Luo ◽  
Yu Lu ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Contextual Information ◽  
Treatment Options ◽  
Test Results ◽  
Patient Portals ◽  
Technology Proficiency ◽  
Intrinsic Factors ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Types Of Information

Background Patients are increasingly able to access their laboratory test results via patient portals. However, merely providing access does not guarantee comprehension. Patients could experience confusion when reviewing their test results. Objective The aim of this study is to examine the challenges and needs of patients when comprehending laboratory test results. Methods We conducted a web-based survey with 203 participants and a set of semistructured interviews with 13 participants. We assessed patients’ perceived challenges and needs (both informational and technological needs) when they attempted to comprehend test results, factors associated with patients’ perceptions, and strategies for improving the design of patient portals to communicate laboratory test results more effectively. Descriptive and correlation analysis and thematic analysis were used to analyze the survey and interview data, respectively. Results Patients face a variety of challenges and confusion when reviewing laboratory test results. To better comprehend laboratory results, patients need different types of information, which are grouped into 2 categories—generic information (eg, reference range) and personalized or contextual information (eg, treatment options, prognosis, what to do or ask next). We also found that several intrinsic factors (eg, laboratory result normality, health literacy, and technology proficiency) significantly impact people’s perceptions of using portals to view and interpret laboratory results. The desired enhancements of patient portals include providing timely explanations and educational resources (eg, a health encyclopedia), increasing usability and accessibility, and incorporating artificial intelligence–based technology to provide personalized recommendations. Conclusions Patients face significant challenges in interpreting the meaning of laboratory test results. Designers and developers of patient portals should employ user-centered approaches to improve the design of patient portals to present information in a more meaningful way.

Sign in / Sign up

Export Citation Format

Share Document