How to use the Manual

The main purpose of this Manual is to provide useful guidelines for the selection of pathology tests and to facilitate interpretation of results.

The Manual consists of several sections:

Clinical problems

The clinical problems listing presents pathology tests in the context of the clinical problems which give rise to the need for diagnostic information. The tests listed are those likely to be useful, but consideration must always be given to the individual clinical situation. Where appropriate, the limitations of tests in providing definitive information are noted. Tests should never be ordered as a 'routine' or 'screen'; an important principle is to request tests only when the results will contribute to diagnosis and/or management.

The clinical problems section is organised in two columns; a line is inserted at the end of each entry.

First column

  • In the first column, the main headings, or primary entries, are the 'clinical problems'.
  • Red dots are provided for ease of reading only.
  • Subheadings indicate various categories, manifestations or complications.
  • Where the clinical problem has an alternative name, or acronym, the column one entry may provide a cross-reference.

Second column

  • There may be a general comment or a definition of the problem, followed by a discussion or listing of appropriate tests.
  • Where comments or tests are appropriate only to the subsidiary entries, they appear across from those subsidiary entries.
  • In general, the tests are described in the same form as they appear in the test listing. Exceptions to this are frequently used tests which are better known by their acronyms (eg, FBC, APTT). However, these appear under their full names in the test listing.
  • If the nature of the specimen is not stated, the required specimen is blood, plasma or serum.
  • When the test requires other body fluids or tissue eg, urine, sputum, CSF or a biopsy, the nature of the required specimen is stated.
  • When different specimens or laboratories are involved in testing, the tests are separated by semi-colons.
  • If a test is not described in the test listing, the comments 'specialised laboratory' or 'consult pathologist' (for further information) are used.
  • If the test is described under a more general test description, a cross-reference to that test is provided.
  • If there is no entry in column two, no useful or additional pathology tests are available.

Pathology tests

  • The pathology test listing includes most of the tests available to the clinician.
  • Tests which are performed infrequently or only in specialised laboratories are not described.
  • The entries are brief. Where further information is required consult the pathologist.
  • Test names reflect common usage.
  • Alternative names for tests are included as cross-references.
  • Other relevant test entries are provided as cross-references.
  • Each entry contains the following information:

Specimen: Comments on the type and volume of the specimen, special requirements and precautions. The specimen volume specified is usually the ideal, rather than the minimum. If multiple tests are being performed on one specimen, the volumes are not additive. Paediatric samples can often be smaller than those generally specified.

Method: A brief description of the methods used and/or the principles of the test.

Reference interval: The 'normal range' for results is provided where this is possible. Many are dependent on analytical method, age, gender and other variables; these variables are described. A therapeutic interval is provided for drug assays.

Application: The indications for performing the test and situations where useful information may be gained. For some tests, comment is made on situations where testing is inappropriate or an alternative test is of more value.

Interpretation: A description of the significance of test results, factors which may influence the result, interpretation of results in specific clinical situations, comment on test sensitivity and specificity and predictive value, where possible.

Reference: One or more books or journal articles which provide further information about the test and its clinical application.

Testing process

The testing process section covers:

  • Requests and collection
  • Blood collection
  • Anatomical pathology
  • Unexpected results

Case scenarios

These are a series of interactive online case scenarios to assist in diagnosis of complex clinical problems. They have been jointly developed with the University of Sydney's Department of Medical Education. Read More.

Test results

The test results section covers the variables that impact upon the validity of laboratory results. These include:

  • Diagnostic tools
  • Validity and reliability
  • Predictive value

Autopsy

A discussion of the decline in autopsy rates and the importance of the autopsy to clinical practice. Read more.

Pathology Decision Support Tools

Pathology Decision Support Tools (PDSTs) help guide referring practitioners requesting pathology tests for the diagnosis and ongoing management and monitoring of patients. A PDST template titled ‘PDST example’ explains the colours used to identify different decision steps in PDSTs. These are:

GREY Boxes

  • Clinical information
  • Further clinical information
  • Result option

YELLOW Boxes

  • Investigations

GREEN Boxes

  • No further action required

BLUE Boxes

  • No immediate treatment
  • Regular review suggested

RED Boxes

  • Diagnosis AND/OR
  • Treatment AND/OR
  • Referral

PDST’s can be downloaded as a JPEG image by using the side bar buttons on the right hand side. .The side bar also contains further explanatory notes on the contents of the PDST. Inside the PDST boxes are numbers linking to clinical information in the side bar

Glossary

Abbreviations have been used for convenience and have been selected on the basis of ease of understanding, common usage and convention. Read more.

Last Updated on Tuesday, 08 March 2011 11:54