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Best practice in primary care pathology: review 4
  1. W S A Smellie1,
  2. J Forth2,
  3. S Sundar3,
  4. E Kalu4,
  5. C A M McNulty5,
  6. E Sherriff4,
  7. I D Watson6,
  8. C Croucher4,
  9. T M Reynolds7,
  10. P J Carey8
  1. 1Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham, UK
  2. 2Sowerby Centre for Health Informatics, Bede House, All Saints Business Centre, Newcastle upon Tyne, UK
  3. 3Department of Oncology, Nottingham City Hospital, Nottingham, UK
  4. 4Department of Obstetrics and Gynaecology, St Helier Hospital, Carshalton, Surrey, UK
  5. 5Health Protection Agency Primary Care Unit, Department of Microbiology, Gloucester Royal Hospital, Great Western Road, Gloucester, UK
  6. 6Department of Clinical Biochemistry, University Hospital Aintree, Longmoor Lane, Liverpool, UK
  7. 7Department of Clinical Chemistry, Queens Hospital, Belvedere Road, Burton on Trent, Staffordshire, UK
  8. 8Department of Haematology, Sunderland Royal Hospital, Kayll Road, Sunderland, UK
  1. 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}


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.

  • 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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  • i Resistance has not increased with over-the-counter antifungals. Samples should be cultured before embarking on long-term suppressive treatment as only 16% with recurrent symptoms have candidiasis.

  • Published Online First 19 May 2006

  • Competing interests: None declared.

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