[How to Interpret Routine Laboratory Data? Challenge Faced by Inexperienced Certified Clinical Laboratory Physicians -Practical Advice from Experienced Certified Clinical Laboratory Physicians -].

Osamu Yonekawa, Takayuki Honda
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Abstract

At the annual meeting of the Japanese Society of Laboratory Medicine in Kobe in 2016, a joint symposium was held in cooperation between the Japanese Society of Laboratory Medicine and Japanese Association of Clinical Laboratory Physicians. We presented and discussed 5 cases at the Reversed Clinico-pathological Conference. Each case was analyzed by 5 new members of the Japanese Association of Clinical Laboratory Physicians, who had passed the examination for Certified Clinical Laboratory Physicians in 2015. After the presentation of their interpretation for basic laboratory tests, the correct diagnosis and useful practical advice were given by experienced Certified Clinical Laboratory Physicians. The first case involved hemolytic anemia due to valve replacement and multiple myeloma with the BJP type. The second case involved primary aldos- teronism with hypokalemia. The third case involved cold agglutination with a high value of MCHC. The fourth case involved pneumonia due to influenza virus. The last case involved diabetic ketoacidosis. All 5 cases were common rather than rare, and any members of the clinical laboratories may encounter them in routine work. A systemic analysis of routine laboratory data can sometimes directly lead to the correct diag- nosis using laboratory data alone and give doctors valuable clinical information on patients. Continuous daily efforts in systemic analysis will ensure that the evaluation skills of inexperienced Certified Clinical Laboratory Physicians in their hospitals will increase. Certified Clinical Laboratory Physicians in clinical laboratories are gatekeepers in every hospital from the viewpoints of both "medical audit" and "risk management".

如何解释常规实验室数据?经验不足的注册临床实验室医生面临的挑战-经验丰富的注册临床实验室医生的实用建议-]。
2016年在神户举行的日本检验医学学会年会上,日本检验医学学会与日本临床检验医师协会合作举办了联合研讨会。我们在逆向临床病理会议上报告并讨论了5例病例。每个病例由5名2015年通过临床检验医师资格考试的日本临床检验医师协会新会员进行分析。在介绍了他们对基本实验室检查的解释之后,经验丰富的注册临床实验室医生给出了正确的诊断和有用的实用建议。第一个病例涉及瓣膜置换术引起的溶血性贫血和BJP型多发性骨髓瘤。第二个病例涉及原发性aldo - teronism伴低血钾。第三例为冷凝集,MCHC值高。第四个病例涉及流感病毒引起的肺炎。最后一例为糖尿病酮症酸中毒。5例病例均为常见病,临床实验室工作人员在日常工作中均有可能遇到。对常规实验室数据的系统分析有时可以直接导致仅使用实验室数据的正确诊断,并为医生提供有关患者的宝贵临床信息。在系统分析方面的持续日常努力将确保医院中缺乏经验的注册临床实验室医师的评估技能将得到提高。无论是从“医疗审计”还是“风险管理”的角度来看,临床实验室注册医师都是每家医院的守门人。
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