The Artery is your community, where you can ask questions, get answers, connect with fellow colleagues, and learn from each other. Many great discussions took place on the Artery throughout 2019, but some received a lot of extra attention. Below are the threads from last year with the highest number of replies. Enjoy re-reading the best of 2019.Fasting Specimen of 75g OGTTInitiated by @Yun Trull, PhD
What protocol do labs follow when deciding whether or not to give a patient a 2h 75g OGTT? Many institutions send a fasting specimen to the main lab for glucose testing, and if the result is too high, they cancel the OGTT. Some labs also screen fasting samples prior to OGTTs with a glucometer. One Canadian lab that uses the glucometer option shared that if the result is above certain cutoffs, they do not administer glucola to the patient, and they then send the fasting sample off for main lab analysis to determine whether the patient has diabetes.Who Collects SWEAT CHLORIDE Specimens at Your Facilities?Initiated by @Seetharam Chittiprol, PhD, ASCP, DABCC, NRCC
The original poster’s lab uses specially-trained lab assistants, but due to high staff turnaround, they can’t keep up with training new staff and their Quantity Not Sufficient rates are too high. They are therefore thinking of switching to using nurses or respiratory therapists and want to know what is standard at other institutes. 9 respondents also use lab staff, 6 use phlebotomists, 4 use nurses, and 2 use respiratory therapists. Most respondents also use a small group of collectors, since this makes it easier to maintain their competency. Lipid "Reference Ranges"Initiated by @Mary Mayo, PhD, ABB, DABCC, MT (ASCP), FAACC
How do labs report “reference ranges” for total cholesterol, LDL, etc. given that a reference range should be the 95% range of normal people, not a recommended ideal number? Respondents agree that for many tests, labs should not use a reference interval, and should instead use clinical decision points to drive flagging in the EMR—with the caveat that some labs do give reference intervals in these cases anyway, even though they aren’t needed, to satisfy CAP/CLIA requirements.