Description
Laboratory tests provide valuable diagnostic and prognostic information as well as helping in monitoring treatment. Like all measurements tests are also prone to errors. These errors can arise before analysis (pre-analytical) during analysis or after analysis. Laboratories are good at reducing analytical errors by introducing internal quality control schemes and external quality assurance schemes. Pre-analytical errors which account for up to 60% of all laboratory errors are more difficult to control. It is important for laboratory professionals to be aware of all the pre-analytical factors that may contribute to errors.
Pre-analytical errors can arise any where from the patient to right up to the time the sample is analysed. In the first article in this issue Claire Meek and Patrick Twomey discuss in detail factors contributing to pre-analytical errors and how to prevent or overcome them.
Another important area where errors can arise in laboratory measurements is from drugs. Drugs can cause interference at the analytical step or by in vivo effects. Thyroid hormone tests are a very significant part of the workload of almost all clinical biochemistry laboratories. Drugs are potential source of errors in thyroid hormone measurements. In addition drugs can cause alterations in the physiology of the hypothalamic-pituitary-thyroid axis and cause various biochemical and clinical abnormalities in thyroid functions. In the second article in this issue Jansen Seheult and Gerard Boran discuss the effects of drugs on the hypothalamic-pituitary-thyroid axis and thyroid hormone concentration.
One of the leading causes of morbidity and mortality in the elderly is osteoporosis. It is estimated that every fourth woman over the age of 80 will get an osteoporosis related fracture, commonly in the vertebrae, hip or the distal forearm. Hip fractures are associated with 20% mortality. Many factors can contribute to the development of osteoporosis. In the final article in this issue Drs Ian Jones, Peter Galloway and Rajeev Srivastava give an update on osteoporosis. They discuss the treatment options currently available and also highlight the possible drugs which may become available in the near future.
Finally, we would like to invite readers to submit interesting case reports that have a particular educational message. The Bulletin will become more lively and interesting with more contribution from readers.
