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The casino of life

¹ Department of Clinical Biochemistry, Royal Infirmary Edinburgh, Room S6114, Level 2, 51 Little France Crescent, Edinburgh EH16 4SA, UK
² Clinical Chemistry Department, Queen’s Hospital, Belvedere Road, Burton upon Trent, Staffordshire, DE13 0RB, UK
³ Department of Chemical Pathology, Guy’s and St Thomas’s Hospital, 5th Floor, North Wing, Lambeth Palace Road, London SE1 7EH, UK

Correspondence to:
Dr P J Twomey
Department of Clinical Biochemistry, Royal Infirmary Edinburgh, Room S6114 Level 2, 51 Little France Crescent, Edinburgh EH16 4SA, UK; taptwomey@aol.com

Keywords: information technology; analytical variation; chronic management; intra-individual variation; screening

The first 150 words of the full text of this article appear below.

Medicine is continuously changing—screening tools, diagnostic assays, and new medications and treatment modalities are rapidly being developed. However, in this age of super fast computers, one question that is not often asked is whether healthcare professionals are making the most of the currently available patient data? Chronic conditions such as diabetes mellitus, hypertension, and dyslipidaemia are increasing in prevalence at an alarming rate. At the same time, treatment guidelines are evolving and the audit of treatment targets is now being instituted as an objective means of measuring quality. However, there is relatively little research into the examination of the effects of such targets for individual patients as opposed to patient populations. We have previously shown that the effect of individual risk factor variation on screening for coronary heart disease can be considerable.¹ So, how can we rationally overcome this variability in the monitoring of chronic clinical conditions? As . . . [Full text of this article]

This article has been cited by other articles:

				P. J. Twomey, A. Viljoen, T. M. Reynolds, and A. S. Wierzbicki Biological Variation in HbA1c Predicts Risk of Retinopathy and Nephropathy in Type 1 Diabetes: Response to McCarter et al. Diabetes Care, October 1, 2004; 27(10): 2569 - 2569. [Full Text] [PDF]