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Best practice in primary care pathology: review 6
  1. W S A Smellie1,
  2. J Forth2,
  3. J J Coleman3,
  4. W Irvine4,
  5. P C Dore5,
  6. G Handley6,
  7. D G Williams7,
  8. P J Galloway8,
  9. K G Kerr9,
  10. R Herriot10,
  11. G P Spickett11,
  12. T M Reynolds12
  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 Clinical Pharmacology, Clinical Investigation Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
  4. 4Department of Microbiology, School of Molecular Medical Sciences, University Hospital, Queen’s Medical Centre, Nottingham, UK
  5. 5Department of Immunology, Hull Royal Infirmary, Anlaby Road, Hull, UK
  6. 6Department of Clinical Biochemistry, Queen Elizabeth Hospital, Gateshead, UK
  7. 7Department of Clinical Biochemistry, Sunderland Royal Hospital, Kayll Road, Sunderland, UK
  8. 8Department of Clinical Biochemistry, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
  9. 9Department of Microbiology, Harrogate District Hospital, Harrogate, UK
  10. 10Department of Immunology, Aberdeen Royal Infirmary, Forresterhill, Aberdeen, UK
  11. 11Department of Immnology, Royal Victoria Infirmary, Newcastle, UK
  12. 12Department of Chemical Pathology, Queen’s Hospital, Burton on Trent, Staffs, UK
  1. 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}


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.

  • 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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  • Published Online First 5 July 2006

  • * These organisations contributed direct funding to support the project start up.

  • This work has been supported (in alphabetical order) by the Association of Clinical Biochemists*, Association of Clinical Pathologists*, Association of Medical Microbiologists, British Society for Haematology, Royal College of General Practitioners, Royal College of Pathologists* and the Sowerby Centre for Health Informatics in Newcastle (SCHIN), representatives of whom have contributed to the reviewing process. The opinions stated are however those of the authors.

  • Competing interests: None declared.