Effective August 8th, Spectrum Health Laboratory will ask all patients to indicate how long they have been fasting (regardless of whether they were fasting or not) when they present for Lipid testing. In light of recent discussions in the literature that debate the utility of fasting prior to lipid testing; we recognize that some clinicians may now not require their patients to be fasting and hope that reporting out length of fasting (hours) with each lipid result will allow all clinicians to better interpret their patient’s lipid results. If fasting is desired; Spectrum Health Laboratory recommends no caloric or caffeine intake for at least 8 hours. The patient is not to drink (other than water), eat, smoke, chew gum, candy, cough drops, etc. for at least 8 hours prior to their blood tests. Prescribed medications are allowed.
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David Alter
Biotin is widely used in immunoassay type laboratory methods over a wide range of instruments at numerous clinical laboratories throughout the world (including Spectrum Health).
With the expansion of biotin – also known as vitamin B7 – supplementation and treatments (“over the counter” and prescription, respectively); an associated interference with many clinical laboratory tests has been identified, confirmed and documented. Unfortunately, magnitude and type (falsely increased/decreased) of interference varies with dose and assay; however, it has been confirmed that as dose increases so does the magnitude of the response. In late November 2017, the Food and Drug Administration (FDA) published a safety alert warning that biotin can interfere with certain lab tests and cause incorrect test results.
Immunochemistry, Test Utilization
Utility of specific IgE (sIgE) testing to foods and food allergen components
The diagnostic evaluation of allergic disease occurs in the context of a patient’s complete clinical presentation. Important factors include, age, clinical signs and symptoms, relevant allergen exposures, and the performance characteristics (sensitivity, specificity, and predictive values) of the allergy tests themselves. Allergy tests yield information about sensitization to allergens, which is not always equivalent to allergic hypersensitivity (i.e., sensitivity); thus, interpretation in the context of clinical history is essential for accurate diagnosis.
In the College of American Pathologists publication CAP Today the question was asked, “Are there regulations guiding the practice of taking additional blood samples from a patient (in case additional testing is needed later) even though there are no orders for the blood samples?” The limited literature on this topic has shown that inpatients (in those studies) have had up to 700 mL of blood collected during hospital stays. Thus we have to step back and ask: Does that make sense?
Read the response offered by David N. Alter, MD, DABCC, Clinical/Chemical Pathologist, Spectrum Health Regional Laboratory.
http://www.captodayonline.com/qa-column-1016/
Tests not performed by Spectrum Health Regional Laboratories (SHRL) will be sent to an appropriate reference laboratory. Mayo Medical Laboratories is our major reference lab; however, not all tests are performed at that location. Please refer to the laboratory test catalog for specific testing locations. (http://spectrumhealth.testcatalog.org/)
As of March 1, 2016, Spectrum Health Laboratory, Grand Rapids, will no longer draw or send a courier for outpatient Ammonia testing (#8074). If outpatient Ammonia testing is needed, the patient must be collected at the 35 Michigan Draw Site. If outpatient Ammonia testing is needed and the patient cannot be drawn at the 35 Michigan Draw Site, approval must be obtained from Dr. David Alter or the Clinical Pathologist on-call, prior to ordering the test.
There will be no changes to inpatient collection. Note: Inpatients are patients who have been admitted to a hospital in the Medical Center (HDVCH, Butterworth, and Meijer Heart Center) or Blodgett Hospital.
Any questions concerning these changes may be directed to the Pathology Department using the Contact Us link above.