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August 2014

Best Tests

Taking responsibility for test results: A discussion

The management of test results, in particular the issue of who is ultimately responsible for following up these results, is at times contentious. There is often a lack of agreement and consistency between clinicians, practices and health organisations as to what is reasonable and practical. This is further complicated when multiple clinicians are involved in the management of a patient, especially when this spans both primary and secondary care. There are numerous pitfalls that can occur when managing patient test results and no management system is likely to be fail-safe. Responsibility for developing an effective method of managing test results lies with both the individual clinician and with the professional community within which they practice, e.g. group practice, hospital department, PHO, DHB. The following commentary is intended to provoke thought and discussion about the challenges faced by clinicians and health organisations in managing test results. View Article

The New Zealand Laboratory Schedule and Test Guidelines: haematology tests

The New Zealand Laboratory Schedule has been created to provide consistent guidance and ensure uniform availability of tests across all District Health Boards (DHBs). The new Schedule divides tests into Tier 1 and Tier 2 to indicate whether all referrers can order the test, i.e. Tier 1, or whether a test must be ordered in conjunction with another health professional with a particular area of expertise, i.e. Tier 2. In addition, clinical guidelines are provided on the use of some tests. In this article we focus on the haematology tests in the schedule. View Article

Investigating myalgia in patients taking statins

Muscle pain (myalgia) and weakness is experienced by up to 10% of patients taking statins. However, myalgia is commonly experienced by all people at some stage in their life, regardless of statin use. To avoid the unnecessary withdrawal of statin treatment, a systematic approach to the investigation of muscle symptoms in patients taking statins is advised. Routine laboratory monitoring for statin-associated adverse effects is not recommended in asymptomatic patients. View Article