^ Back to Top

April 2015

Best Tests

Factors that can affect laboratory investigations

In 2013 we published an article entitled “Best tests?” (Best Tests 18; Feb, 2013). In this article we challenged clinicians to consider whether they could improve the method and manner in which they request laboratory investigations. To put it simply, it is about selecting the right test, at the right time, for the right patient. After making the decision that an investigation is necessary, and selecting the most appropriate test, consideration must be given to what factors are present that may affect the interpretation of results, or even the decision to proceed with the test at that time. View Article

The New Zealand Laboratory Schedule and Test Guidelines: Anatomic Pathology Tests

The New Zealand Laboratory Schedule provides clinicians with consistent guidance when considering requesting laboratory tests. It will ensure the uniform availability of tests across District Health Boards (DHBs) in the future. Tests are divided into Tier 1, which all referrers can order, and Tier 2, meaning that the test must be ordered in conjunction with another health professional with a particular area of expertise. In addition, clinical guidance is provided on the use of some tests. In this article, with the assistance of Dr Cynric Temple-Camp (Chair of the Laboratory Schedule Anatomic Pathology subgroup), we focus on the anatomic pathology tests in the Schedule. View Article

Identifying and managing hereditary haemochromatosis in adults

Hereditary haemochromatosis is the most common genetic disease in European populations. It is an autosomal recessive disorder which leads to elevated iron absorption. This in turn can lead to iron deposition in tissue which adversely influences organ function, leading to a range of complications, such as arthralgia, diabetes, heart disease, liver cirrhosis and hepatocellular carcinoma. Patients who have biochemical evidence of abnormal iron metabolism, measured by ferritin levels and transferrin saturation, require genetic testing after excluding non-specific causes of ferritin elevation. Treatment of haemochromatosis aims to reduce body iron stores by regular venesection until target ferritin levels are reached. Venesection reduces the risk of some complications, but not others, and continued monitoring of iron levels and possible clinical consequences is necessary. View Article