REVIEW

Best practice in primary care pathology: review 5

W S A Smellie¹, J Forth², S Ryder³, M J Galloway⁴, A C Wood⁵ and I D Watson⁶

¹ Department of Chemical Pathology, Bishop Auckland General Hospital, Durham, UK
² Sowerby Centre for Health Informatics, Bede House, All Saints Business Centre, Newcastle upon Tyne, UK
³ Department of Gastroenterology, Queen’s Medical Centre, Nottingham, UK
⁴ Department of Haematology, City Hospitals Sunderland NHS Trust, Sunderland Royal Hospital, Sunderland, UK
⁵ Department of Haematology, James Cook University Hospital, Teesside, UK
⁶ Department of Clinical Biochemistry, University Hospital Aintree Liverpool, UK

Correspondence to:
Correspondence to:
W S A Smellie
Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK;info{at}smellie.com

This fifth best practice review examines three series of common primary care questions in laboratory medicine: (1) minor liver function test abnormalities; (2) laboratory monitoring of patients receiving lithium; and (3) investigation of possible venous thromboembolism. The review is presented in question–answer format, referenced for each question series. The recommendations represent a precis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most are consensus-based rather than evidence-based. They will be updated periodically to take account of new information.

Abbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate transaminase; BNF, British National Formulary; DVT, deep venous thrombosis; GGT, -glutamyl transpeptidase; GMS, General Medical Services; NAFLD, non-alcoholic fatty liver disease; ULN, upper limit of normal

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