Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
LifeLabs, Toronto, Ontario, Canada.
Can J Cardiol. 2021 Jun;37(6):933-937. doi: 10.1016/j.cjca.2021.03.018. Epub 2021 Mar 26.
To effectively implement the Canadian Cardiovascular Society (CCS) guidelines for dyslipidemia management into clinical laboratories, clear recommendations for lipid reporting are essential. In this study, the Canadian Society of Clinical Chemists Working Group on Reference Interval Harmonisation surveyed Canadian laboratories on adult lipid reporting practices to set a foundation for the development and implementation of harmonised lipid reporting across Canada. Key aspects of the survey asked laboratories: what reporting parameters were in place to assess lipid results; what interpretative comments were provided; whether nonfasting lipids were permitted and, if so, what strategy was used to document fasting status; and whether there was interest in implementing a harmonised lipid report. A total of 101 laboratories were represented by 24 respondents, as many responses were submitted by laboratory networks that included more than 1 laboratory. There was at least 1 response from 9 Canadian provinces and representation across 5 testing platforms. Upper and lower limits for lipid parameters and referenced source of limits varied substantially across laboratories, with only 56% of laboratories (9 respondents) referencing the 2016 CCS guidelines. Eighty-six percent of laboratories (19 respondents) report nonfasting lipids, although the method of documenting nonfasting status varied. Overall, 36% of laboratories (8 respondents) reported interest in implementing a harmonised lipid report. Assessment of current lipid-reporting practices supports the need for harmonised lipid reporting across Canada. Development of a harmonised lipid report for the adult population, consistent with up-to-date Canadian guidelines, will improve continuity of lipid test interpretation across Canada and improve clinical decision making.
为了将加拿大心血管学会(CCS)的血脂异常管理指南有效地应用于临床实验室,明确的脂质报告建议至关重要。在这项研究中,加拿大临床化学学会参考区间协调工作组调查了加拿大的实验室,了解成人脂质报告实践情况,为在加拿大范围内制定和实施协调一致的脂质报告奠定基础。调查的关键方面询问了实验室:评估脂质结果的报告参数有哪些;提供了哪些解释性评论;是否允许进行非空腹脂质检测,如果允许,使用什么策略来记录空腹状态;是否有兴趣实施协调一致的脂质报告。共有 101 家实验室由 24 名受访者代表,许多回复是由包含 1 家以上实验室的实验室网络提交的。加拿大 9 个省至少有 1 个实验室回复,涵盖了 5 个检测平台。脂质参数的上限和下限以及参考限值来源在实验室之间差异很大,只有 56%的实验室(9 名受访者)参考了 2016 年 CCS 指南。86%的实验室(19 名受访者)报告非空腹脂质检测,尽管记录非空腹状态的方法有所不同。总体而言,36%的实验室(8 名受访者)表示有兴趣实施协调一致的脂质报告。目前脂质报告实践情况的评估支持加拿大范围内协调一致的脂质报告的需求。为成年人制定与最新加拿大指南一致的协调一致的脂质报告将提高加拿大各地脂质检测解释的连续性,并改善临床决策。