Biochemistry, biochemical testing, and specialist biochemical practitioners have an important role in clinical practice in both diagnosis and management, as emphasized by the fact that some discussion of biochemical testing appears in almost every chapter of this book. Included in this chapter are (1) a listing of the reference intervals (formerly termed reference ranges) for the most widely used biochemical tests, with conversion factors included (where appropriate) to convert intervals from SI to conventional units, and their grouping into organ system profiles in common usage; (2) description of the pitfalls and limitations of interpretation of reference intervals; and (3) some commonly used protocols for dynamic function tests....
Monitoring tests form an increasing proportion of the workload in clinical biochemistry and biochemists can help by providing clinicians with information about the variability and precision of tests, the time frame for pharmacodynamic stabilisation after a treatment change, and the frequency of testing. This paper outlines the phases of monitoring, and how to decide if monitoring is beneficial, which test to use for monitoring, when a change in the test result indicates a need for the change in treatment and the length of testing intervals. We conclude with some recommendations for biochemists for future areas of research and advice that can be given to clinicians.
As the population ages and the prevalence of chronic disease in the community rises, patients require more monitoring and over longer periods of time. Monitoring tests are taking up a larger proportion of the tests undertaken in a clinical laboratory. Testing of lipid levels is an example: data on cholesterol testing in Oxfordshire, UK, shows that the number of patients who have two or more cholesterol tests in a three year period has grown at an exponential rate over the last two decades.
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