REVIEW

Best practice in primary care pathology: review 6

W S A Smellie¹, J Forth², J J Coleman³, W Irvine⁴, P C Dore⁵, G Handley⁶, D G Williams⁷, P J Galloway⁸, K G Kerr⁹, R Herriot¹⁰, G P Spickett¹¹, T M Reynolds¹²

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 Clinical Pharmacology, Clinical Investigation Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
⁴ Department of Microbiology, School of Molecular Medical Sciences, University Hospital, Queen’s Medical Centre, Nottingham, UK
⁵ Department of Immunology, Hull Royal Infirmary, Anlaby Road, Hull, UK
⁶ Department of Clinical Biochemistry, Queen Elizabeth Hospital, Gateshead, UK
⁷ Department of Clinical Biochemistry, Sunderland Royal Hospital, Kayll Road, Sunderland, UK
⁸ Department of Clinical Biochemistry, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
⁹ Department of Microbiology, Harrogate District Hospital, Harrogate, UK
¹⁰ Department of Immunology, Aberdeen Royal Infirmary, Forresterhill, Aberdeen, UK
¹¹ Department of Immnology, Royal Victoria Infirmary, Newcastle, UK
¹² Department of Chemical Pathology, Queen’s Hospital, Burton on Trent, Staffs, UK

Correspondence to:
Dr 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 sixth best practice review examines four series of common primary care questions in laboratory medicine: (1) laboratory monitoring in hypertension and heart failure abnormalities; (2) markers of inflammatory joint disease; (3) laboratory investigation of chronic diarrhoea; and (4) mumps and chickenpox. The review is presented in question–answer format, referenced for each question series. The recommendations represent a precis of 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 are consensus based rather than evidence based. They will be updated periodically to take account of new information.

Abbreviations: ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor antagonists; CRP, C reactive protein; eGFR, estimated glomerular filtration rate; ESR, erythrocyte sedimentation rate; FBC, full blood count; GFR, glomerular filtration rate; GMS, General Medical Services; HLA, human leucocyte antigen; RhF, rheumatoid factor; SpA, spondyloarthritides; VZIG, varicella-zoster immunoglobulin; VZV, varicella-zoster virus

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