Errors in laboratory tests are most often the fault of patients, not the centers performing them – said Synevo’s medical director, Dr. Andrzej Marszałek, at a press breakfast in Warsaw on Monday.
The specialist emphasized that he did not blame the patient for the fact that the test result sometimes did not reflect his actual state of health. He emphasizes that only 3 out of 1000 tests performed are flawed. 75 percent Test errors arise at the pre-laboratory stage, not during the test. Most often they are caused by a patient who has prepared for them incorrectly – emphasizes Dr. Marszałek.
Doctors do not always tell the patient how to prepare for the examination, as they usually do not have time to do so. Meanwhile, patients make even basic mistakes. They do not come for the examination on an empty stomach because they think there is no harm in drinking coffee. And it is enough to eat dinner too late, and abundant in addition, for the test to be unreliable – adds the specialist.
Medical Director of the Hospital Saint Elżbieta in Warsaw, family medicine specialist and dietitian, Dr. Dariusz Rembisz pointed out that before the examination you must fast for at least 12 hours. The day before, dinner should be eaten at 19.00 p.m. at the latest, it would be better if it was easy to digest and low in calories. If we eat breakfast in the morning, after 2 hours we will have elevated levels of triglycerides, glucose, phosphates and potassium – he added.
Blood pressure measurement should only be performed in a sitting position and after 15-20 minutes of rest, otherwise it will be overstated. Our mental state is very important. When we are stressed, if only because we have waited too long for the test, the level of cortisol, the so-called stress hormone, which in turn can increase blood glucose levels, which will falsify the test for diabetes – explained Dr. Rembisz. For this reason, the concentration of insulin, thyroid hormone TSH, catecholamines (used in the diagnosis of some cancer-producing neoplasms), lactates, cholesterol and prolactin (PRL) may also be too high.
Dr. Marszałek pointed out that the position of the body before the examination is important to obtain a reliable result. Waiting in line before collecting blood while standing up can increase your hemoglobin (Hb), total calcium, immunoglobulin, albumin, alkaline phosphatase (ALP), triglycerides, and total cholesterol, as well as bad cholesterol (LDL) and good cholesterol (HDL).
The method of blood collection by the nurse is also important – emphasizes Dr. Marszałek. Too long pressure on the arm causes the blood to thicken in the vessel in the area of its collection, which activates the clotting factors. This, in turn, may lead to elevated levels of many other substances: alanine aminotransferase (ALT), lattice kinase (CK), bilirubin, lactate dehydrogenase (LDH), albumin, total protein, cholesterol, calcium, and red blood cells (RBC). However, the level of glucose, phosphate, urea, creatinine and white blood cells (Leu) may be reduced.
According to Dr. Rembisz, it is best to check in in the morning, not in the afternoon, after work. Do not compare the results of tests performed at different times, because hormone levels change during the day. For example, the concentration of cortisol and growth hormone is twice as high as at 6.00 am than at midnight, and renin and aldosterone are lowest in the afternoon.
You should also remember not to keep the urine collected in the container. From its collection to its analysis in the laboratory, it should not take more than 6 hours – added Dr. Marszałek.
According to prof. Dariusz Sitkiewicz from the laboratory medical diagnostics department of the Medical University of Warsaw, the center where we perform the tests should have a certificate confirming that it participates in the National Central Program of Interlaboratory Testing and meets the required criteria for the correctness of the results.
The specialist cited data showing that laboratory tests provide 70 percent. information necessary for diagnosis and is the basis of nearly two-thirds of treatment decisions. For the effective use of laboratory results, it is very important that the doctor cooperates with the laboratory, both when ordering tests and when interpreting the obtained results – added Prof. Sitkiewicz.