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 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 the 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
As always, few test results point to an immediate course of action and the
interpretation of any result must always take into account 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.