Association of biochemical values with morbidity in the elderly: a population-based Swedish study of persons aged 82 or more years.

Background: Various inter-dependent factors influence serum biochemical values. In the elderly, the impact of these factors may differ compared with younger age groups and therefore population-based studies among older people are needed. The specific morbidity in old age, including also various types of drug therapy, should be observed.

Biochemical values in persons older than 82 years of age: report from a population-based study of twins.

According to international standards, reference values for biochemical tests should be obtained in disease-free subjects and for therapies that may influence measurement values. For elderly persons, especially the very old, such a requirement is difficult to meet, since few of these individuals are free of ongoing or former diseases. The present study of a population-based Swedish twin sample comprises 535 individuals (186 males, 349 females) who were at least 82 years of age at blood sampling.

[Wide variations among hospitals in use of laboratory tests. Information and education to increase cost-effectiveness].

Hospitals in Sweden differ greatly in their use of laboratory tests. These differences seem to be due to traditions and regional differences. The cost of a single laboratory test is often low, but since many tests are used in great numbers, the consequences of false or misleading results can be very costly.

Reminders of drug effects on laboratory test results.

Drug effects on laboratory test results are difficult to take into account without an online decision support system. In this study, drug effects on hormone test results were coded using a drug-laboratory effect (DLE) code. The criteria that trigger the reminders were defined.

Large differences in laboratory utilisation between hospitals in Sweden.

There are large differences in the use of laboratory tests between hospitals in Sweden. These differences are not only due to differences between the patients treated but also to differences in practice. Use of laboratory test seems to reflect local traditions to a large extent.

Effects of an education programme to change clinical laboratory testing habits in primary care.

Objective: The aim of this study was to investigate the use of clinical laboratory tests in primary care and to evaluate if it is possible to improve the cost-effectiveness of laboratory testing by a short-term education programme. Our main goal has been to lower the total costs of care.

Design: An education programme that was monitored by laboratory test ratios.

Towards common reference intervals in clinical chemistry. An attempt at harmonization between three hospital laboratories in Skåne, Sweden.

The population sample of the Kristianstad survey, a reference intervals survey in the county of Kristianstad, was used to establish new reference intervals in clinical chemistry at the laboratories of the Central Hospital in Kristianstad, the University Hospital in Lund and the University Hospital in Mälmo. Three-hundred and fifty nine subjects, male and female, aged 20-80+ years, were invited to participate in the study, with a participation rate of 70%. Up to 70 analyses were performed on each subject, general clinical chemistry parameters in all three laboratories, specialized analyses where available.

Measurement of C-reactive protein and the erythrocyte sedimentation rate in general practice.

Objective: To evaluate the NycoCard:::CRP test (Nycomed A/S, Oslo, Norway) in relation to ESR in consecutive patients in general practice. NycoCard:::CRP test was also compared with a reference method for CRP quantitation.

Design: C-reactive protein and ESR were simultaneously measured in 607 consecutive patients at four community health centres.

[Troponin T in acute myocardial infarction. Diagnosis and prognosis in patients admitted for suspected acute myocardial infarction].

Cardiac troponin T (TnT) is a new serological marker for use as a diagnostic tool for myocardial damage. A blinded prospective multicentre study representing 298 patients who on admission were suspected of acute myocardial infarction (AMI) to the coronary care units of six Scandinavian hospitals was undertaken to assess the diagnostic performance and prognostic efficacy of a new cardiospecific TnT immunoassay. We used a discriminator value of TnT of 0.

Reference intervals and decision limits for plasma lipids and lipoproteins: a practical evaluation of current recommendations.

As part of a longitudinal study--the Kristianstad Survey--we measured plasma cholesterol, HDL- and LDL-cholesterol, triglycerides and lipoprotein (a) in a reference group consisting of 203 men and women aged 20-80, randomly sampled from a well-defined area in the southernmost part of Sweden. The selection of reference individuals and the collection of specimens for assay of the constituents were performed in accordance with current recommendations. The results were subjected to statistical analyses both with and without application of exclusion criteria.

Diagnostic performance and prognostic value of serum troponin T in suspected acute myocardial infarction.

Cardiac troponin T (TnT) is a new serological marker for use as a diagnostic tool for myocardial damage. A blinded prospective multicentre study representing 298 patients suspected of having acute myocardial infarction (AMI), and admitted to the coronary care units of six Scandinavian Hospitals was undertaken to assess the diagnostic performance and prognostic efficacy of a new cardiospecific TnT immunoassay. We used a discriminator TnT value of 0.

Increased CKMB (mass concentration) in patients without traditional evidence of acute myocardial infarction. A risk indicator of coronary death.

A study of 102 patients consecutively admitted to a coronary care unit (CCU) investigated the clinical usefulness of three different immunoenzymometrical CKMB methods: NovoClone CK-MB, ICON QSR CKMB and IMx CK-MB. Blood samples were drawn on admission and then every 6 h for 48 h. The three different methods correlated very well (r = 0.

Decentralized laboratory testing: attitudes of physicians and medical students.

Attitudes regarding the use of decentralized laboratory testing were examined in two groups of district physicians (DP; n = 15), a group of physicians undergoing postgraduate training as specialists in general medicine (PP; n = 17), and a group of medical students who had completed five years of basic studies (MS; n = 15). A sorting test was employed involving 56 cards with names of laboratory tests presently or soon available for use within primary health care. The DPs showed a relatively high consensus concerning which analyses were needed most for near-to-patient testing.