Posted by Sten Westgard, MS
Following up on the previous post on what doctors know about laboratory testing, here's another survey plumbing the depths of their knowledge. This study is a survey of general practitioners, intern doctors, and medical students in Spain:
The degree of knowledge shown by physicians in relation to the variability of laboratory test results.
Emilio Flores, Maria Leiva, Carlos Leiva-Salinas and Maria Salinas
Clin Chem Lab Med 2009;47(3):381-382.
What do you think they found?
In the survey, participants were asked if they could identify (1) the within-subject biologic variability, and (2)the desirable analytical variability, of 13 common tests (Bilirubin, CA-125, Calcium, Cholesterol, Creatinine, Ferritin, Glucose, Iron, PSA, CRP, TSH, Triglycerides, and Urea). The answers they were allowed to choose included <5%, 5%-10%, 10%-20%, or >20%.
The survey results revealed that less than 50% of doctors could identify the desirable analytical precision or the within-subject biologic variation of any of the tests. For tests like Bilirubin, no doctors could identify the biologic variation and less than 2% of doctors could identify the desirable precision. The best they did was with calcium: 40% could identify the biologic variation, while 43% could identify the desirable precision.
The entire survey results are worth looking at, but they make very clear the fact that doctors are unaware of the extent of variation in laboratory testing. It's proof that they believe we're doing a better job than we really are.
This also confirms that laboratory professionals truly are vital. We're the only ones who understand variation and the intricacies of test results (or at least we're in a better position to do so). The doctors and nurses may not realize ity, but they are dependent upon our knowledge.
Happy Lab Week.
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