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Best practice in primary care pathology: review 11
  1. W S A Smellie1,2,3,4,
  2. M P J Vanderpump1,2,3,4,
  3. W D Fraser1,2,3,4,
  4. R Bowley1,2,3,4,
  5. N Shaw1,2,3,4
  1. 1
    Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK
  2. 2
    Department of Endocrinology, Royal Free Hampstead NHS Trust, Pond St, London NW3 2QG, UK
  3. 3
    Department of Clinical Chemistry, Loyal Liverpool University Hospital, Duncan Building, Prescot St, Liverpool L69 3GA, UK
  4. 4
    Sowerby Centre for Health Informatics, Bede House, All Saints Business Centre, Newcastle upon Tyne NE1 2ES, UK
  1. W S A Smellie, Department of Chemical Pathology, Bishop Auckland General Hospital, Cockton Hill Road, Bishop Auckland, County Durham DL14 6AD, UK; stuart.smellie{at}


This eleventh best practice review examines two series of common primary care questions in laboratory medicine: (i) thyroid testing, and (ii) hypercalcaemia and hypocalcaemia. The review is presented in the same question–answer format as in the previous reviews. These questions and answers deal with common situations in men and non-pregnant women. The recommendations represent a précis 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. In the case of the thyroid series, the recommendations are drawn from the 2006 guidelines published by the Association for Clinical Biochemistry, the British Thyroid Association and the British Thyroid Foundation. They are not standards but form a guide to be set in the clinical context. Most are consensus rather than evidence based. They will be updated periodically to take account of new information.

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

  • Competing interests: None.