REVIEW

Best practice in primary care pathology: review 4

W S A Smellie¹, J Forth², S Sundar³, E Kalu⁴, C A M McNulty⁵, E Sherriff⁴, I D Watson⁶, C Croucher⁴, T M Reynolds⁷, P J Carey⁸

¹ Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham, UK
² Sowerby Centre for Health Informatics, Bede House, All Saints Business Centre, Newcastle upon Tyne, UK
³ Department of Oncology, Nottingham City Hospital, Nottingham, UK
⁴ Department of Obstetrics and Gynaecology, St Helier Hospital, Carshalton, Surrey, UK
⁵ Health Protection Agency Primary Care Unit, Department of Microbiology, Gloucester Royal Hospital, Great Western Road, Gloucester, UK
⁶ Department of Clinical Biochemistry, University Hospital Aintree, Longmoor Lane, Liverpool, UK
⁷ Department of Clinical Chemistry, Queens Hospital, Belvedere Road, Burton on Trent, Staffordshire, UK
⁸ Department of Haematology, Sunderland Royal Hospital, Kayll Road, Sunderland, UK

Correspondence to:
W S A Smellie
Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK; info{at}smellie.com

This fourth best practice review examines four series of common primary care questions in laboratory medicine are examined in this review: (1) safety monitoring for three common drugs; (2) use of prostate-specific antigen; (3) investigation of vaginal discharge; and (4) investigation of subfertility. The review is presented in question–answer format, referenced for each question series. The recommendations represent a precis of the guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most of them are consensus based rather than evidence based. They will be updated periodically to take account of new information.

Abbreviations: BNF, British National Formulary; DRE, digital rectal examination; FSH, follicular stimulating hormone; GMS, General Medical Services; HVS, high vaginal swab; NHS, National Health Service; NICE, National Institute of Health and Clinical Excellence; PCOS, polycystic ovary syndrome; PID, pelvic inflammatory disease; PSA, prostate-specific antigen; SFA, seminal fluid analysis; STI, sexually transmitted infection; TFT, thyroid function test; TSH, thyroid-stimulating hormone

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