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Published Online First: 5 July 2006. doi:10.1136/jcp.2006.040014
Journal of Clinical Pathology 2007;60:225-234
Copyright © 2007 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.

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REVIEW

Best practice in primary care pathology: review 6

W S A Smellie1, J Forth2, J J Coleman3, W Irvine4, P C Dore5, G Handley6, D G Williams7, P J Galloway8, K G Kerr9, R Herriot10, G P Spickett11, T M Reynolds12

1 Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham, UK
2 Sowerby Centre for Health Informatics, Bede House, All Saints Business Centre, Newcastle upon Tyne, UK
3 Department of Clinical Pharmacology, Clinical Investigation Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
4 Department of Microbiology, School of Molecular Medical Sciences, University Hospital, Queen’s Medical Centre, Nottingham, UK
5 Department of Immunology, Hull Royal Infirmary, Anlaby Road, Hull, UK
6 Department of Clinical Biochemistry, Queen Elizabeth Hospital, Gateshead, UK
7 Department of Clinical Biochemistry, Sunderland Royal Hospital, Kayll Road, Sunderland, UK
8 Department of Clinical Biochemistry, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
9 Department of Microbiology, Harrogate District Hospital, Harrogate, UK
10 Department of Immunology, Aberdeen Royal Infirmary, Forresterhill, Aberdeen, UK
11 Department of Immnology, Royal Victoria Infirmary, Newcastle, UK
12 Department of Chemical Pathology, Queen’s Hospital, Burton on Trent, Staffs, UK

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
ABSTRACT
This sixth best practice review examines four series of common primary care questions in laboratory medicine: (1) laboratory monitoring in hypertension and heart failure abnormalities; (2) markers of inflammatory joint disease; (3) laboratory investigation of chronic diarrhoea; and (4) mumps and chickenpox. 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: ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor antagonists; CRP, C reactive protein; eGFR, estimated glomerular filtration rate; ESR, erythrocyte sedimentation rate; FBC, full blood count; GFR, glomerular filtration rate; GMS, General Medical Services; HLA, human leucocyte antigen; RhF, rheumatoid factor; SpA, spondyloarthritides; VZIG, varicella-zoster immunoglobulin; VZV, varicella-zoster virus




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