Published 2011, 258 pp
Laboratory investigations are part of the diagnosis and monitoring of a large proportion of diseases encountered in primary care and are increasing in number and complexity. This increase, however, does not seem to be matched by greater teaching of laboratory medicine in medical and nursing schools; if anything such teaching has declined.
This book sets out to consider a wide range of the questions that are frequently asked of laboratory medicine specialists by primary care practioners. It is intended as a guide for doctors, nurses, those in training, and perhaps also the laboratory specialist who is looking for brief guidance on unfamiliar topics. In many cases the questions have no single right answer, but what is offered is a review of the guidance available nationally and internationally to seek to offer ‘the best answer we can’.
When a test result is obviously very abnormal it usually provides a clear indication of the next course of action required, whether this be referral or treatment. Less pronounced abnormalities, however, are far more difficult to interpret, and because of uncertainty over the implications of the result,may often lead to patient referral or, at very least, concern. Among the many topics considered here, we have tried to pay particular attention to the ‘slightly abnormal’ result and to guide practitioners through the further management options.
As always, few test results point to an immediate course of action and the interpretation of any result must always take account of the individual patient’s symptoms and underlying health. That said, we hope the guidance in this book will provide some practical ways forward in dealing with the more common problems that arise in primary care.
We are hugely grateful to William Marshall and Beverley Harris for their patience and detailed editing of both language and scientific content, to Roy Sherwood for the design and layout of the book and to Alan Sherwood for the cover design. We are also grateful to the many colleagues who have contributed their expertise to our work, in particular to those whose names are acknowledged at the end of individual sections.