COMMENTARY

Laboratory Results That Should Be Ignored

Dirk M. Elston, MD

Disclosures

October 11, 2006

Bridges Between the Laboratory and Clinic

There are noteworthy models of whichspecialty societies representing both laboratory and clinical medicine have collaborated to create standards for reporting that define laboratory results that should be ignored, those that should be followed, and those that require action. One example is the reporting of atypical squamous or glandular cells in gynecologic cytology specimens.[59,60,61] Another example is the interpretation of weakly or moderately positive antinuclear antibody (ANA) tests.[62] As treatment options and the technology that is used to prepare specimens for interpretation continue to evolve, such published standards must be dynamic in order to remain clinically useful.[63,64]

Novel diagnostic tests represent a particular challenge. Longitudinal algorithms that compare the new test with previous methods are required to validate new markers. Longitudinal algorithms have been successfully employed for prostate-specific antigen and CA125 assays for the detection of prostate and ovarian cancer, and the parametric empirical Bayes screening algorithm has been proposed as a method for evaluating new tumor markers.[65]

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