Changing reference ranges needlessly alarms patients with results in hand

LETTER — Posted Nov. 28, 2011

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Regarding "HHS wants to give patients test results straight from lab" (Article, Oct. 3): This is not a good idea, because there is an increasing tendency to change the reference range for many tests.

The most common example is the glucose, where some labs have 99 as the top level, others use 105, others 110. The American Diabetes Assn. uses 126. Many patients are referred to me needlessly because their serum glucose falls a point or two above the printed range.

Also, the lipid levels have come down through the years. Normal for cholesterol was 240 a few years back; now it is under 200. Triglyceride was practically ignored a generation ago. Now the normal level is less than 150.

When patients receive these test results, we have to walk them through it. Once, a computer error on the CBC results were way off, and the patient arrived in a panic and thought she had leukemia!

I make it a policy to meet with a patient within a week after their lab work is taken to review (with a red pen) the results. I don't want them to feel like giving up if they are doing well.

Arnold Chanin, MD, El Segundo, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/11/28/edlt1128.htm.

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