Episode 354: Reporting lab results - the cause of, and the solution to, the overdiagnosis problem – Part III

In episode 354, James and Mike continue to delve into the issues around lab reporting and measurements. In this part, we talk about the variation seen with blood pressure measurements, glucose and Vitamin D as further examples of what clinicians need to be aware. Having this insight should give you more confidence to interpret lab values, or just frustrate the heck out of you. You decide. 

Show notes



I was more surprised by this podcast than I was expecting to be.  I just graduated from family medicine residency and can say that the majority of times lab results were just 5-10% out of the reference range, we were expected to get further workup.  This has been especially true for AST/ALT levels.  I can't count the number of times I've worked someone up for NAFLD at the direction of my advisors with AST/ALT levels in the 50s.  I find it shocking that lab results can be as high as +/- 60% with analytic and biologic variance.  One question I have is regarding the number of test ordered.  Is this in ordering the same test? It seems that each test you ordered would be independent of each other.  I don't understand how ordering 1 test could have a 5% chance of abormal result and ordering 20 test could have a 64% chance of having an abnormal result?