Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: ©Croatian Society of Medical Biochemistry and Laboratory Medicine.
Copyright: 2020, Croatian Society of Medical Biochemistry
License (open-access):
This is an Open Access article distributed under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 12 May 2020
Date accepted: 23 September 2020
Publication date (electronic): 15 December 2020
Publication date (print): 15 February 2021
Volume: 31
Issue: 1
Electronic Location Identifier: 010703
Publisher ID: bm-31-1-010703
DOI: 10.11613/BM.2021.010703
Using clinical guidelines to assess the potential value of laboratory medicine in clinical decision-making
Allan J. Hicks[1]
Zoe L. Carwardine[2]
Mike J. Hallworth[3]
[1] School of Medical Science, Griffith University, Southport, Australia
[2] Clinical Biochemistry, Sidra Medicine, Doha, Qatar
[3] Clinical Biochemistry, Royal Shrewsbury Hospital, Shrewsbury, UK
[4] Department of Clinical Biochemistry, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
Author notes:
[*] Corresponding author: Eric.Kilpatrick@mft.nhs.uk
Introduction
It is often quoted that 70% of clinical decisions are based on laboratory results, but the evidence to substantiate this claim is lacking. Since clinical guidelines aim to document best-practice decision making for specific disease conditions, inclusion of any laboratory test means that the best available evidence is recommending clinicians use it. Cardiovascular disease (CVD) is the world’s most common cause of mortality, so this study reviewed all CVD guidelines published by five national/international authorities to determine what proportion of them recommended laboratory testing.
Materials and methods
Five leading CVD guidelines were examined, namely the European Society of Cardiology (ESC), the UK National Institute for Health and Clinical Excellence (NICE), the American College of Cardiology (ACC), the Australian Heart Foundation (AHF) and the Cardiac Society of Australia and New Zealand (CSANZ).
Results
A total of 101 guidelines were reviewed. Of the 33 individual ESC guidelines relating to CVD, 24/33 made a direct reference to the use of clinical laboratory tests in either diagnosis or follow-up treatment. The same applied to 15/20 of NICE guidelines, 24/32 from the ACC and 15/16 from the AHF/CSANZ. Renal function and blood count testing were the most recommended (39 and 26 times), with lipid, troponin and natriuretic peptide measurement advocated 25, 19 and 19 times respectively.
Keywords: cardiovascular diseases; guideline; clinical laboratory testing
