REVIEW

Best practice in primary care pathology: review 2

W S Smellie¹, J O Forth², C A M McNulty³, L Hirschowitz⁴, D Lilic⁵, R Gosling⁶, D Bareford⁷, E Logan⁸, K G Kerr⁹, G P Spickett¹⁰, J Hoffman¹, A Galloway¹¹ and C A Bloxham¹

¹ Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK
² Prodigy, Sowerby Centre for Health Informatics, Bede House, All Saints Business Céntre, Newcastle Upon Tyre NEI 2ES, UK
³ Health Protection Agency Primary, Care Unit, Microbiology Department, Gloucester Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK
⁴ Department of Cellular Pathology, Royal United Hospital, Combe Park, Bath BA1 3NG, UK
⁵ University Hospital of North Durham, North Road, Durham DH1 5TW, UK
⁶ Darlington Memorial Hospital, Hollyhurst Road, Darlington, County Durham DL3 6HX, UK
⁷ Russells Hall Hospital, Dudley, West Midlands DY1 2HQ, UK
⁸ Department of Haematology, Kings Mill Centre, Mansfield Road, Sutton in Ashfield, Nottingham NG17 4JL, UK
⁹ Department of Microbiology, Harrogate District Hospital, Lancaster Park Road, Harrogate, North Yorkshire HG2 7SX, UK
¹⁰ Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK
¹¹ Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK

Correspondence to:
Correspondence to:
Dr 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 second best practice review examines five series of common primary care questions in laboratory medicine: (1) laboratory testing for allergy, (2) diagnosis and monitoring of menopause, (3) the use of urine cytology, (4) the usefulness of the erythrocyte sedimentation rate, and (5) the investigation of possible urinary tract infection. The review is presented in a question–answer format. The recommendations represent a précis 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 standards but form a guide to be set in the clinical context. Most are consensus rather than evidence based. They will be updated periodically to take account of new information.

Abbreviations: AUA, American Urological Association; FSH, follicle stimulating hormone; GMS, General Medical Services; MH, microscopic haematuria; RAST, radioallergosorbent testing; UTI, urinary tract infection

Keywords: appropriateness; best practice; interdisciplinary; primary care

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