Provision of laboratory services for lipid analysis in the United Kingdom.

Background: National guidelines have been developed in the UK to reduce coronary heart disease mortality. This audit assesses provision of lipid analyses by UK Clinical Biochemistry services to support their implementation.

Methods: Audit standards were derived from published guidelines. A questionnaire based on these was circulated to all UK Clinical Biochemistry laboratories.

Results: Of 108 replies, routine lipid profiles included triglycerides, HDL-, LDL-cholesterol and total:HDL cholesterol ratio in 98, 85, 72 and 44%, respectively. Only 33% and 27% analysed triglycerides and HDL, respectively, when asked simply to measure cholesterol. Seventy-six percent of the reports stated whether specimens were collected after fasting. For primary prevention, 46% of laboratories stated results should be interpreted in association with other risk factors; 20% referred explicitly to national/local guidelines. Only 19 laboratories quoted secondary prevention treatment thresholds for total cholesterol or LDL-cholesterol. Sixty laboratories occasionally added extra tests and/or interpretive comments. Eight laboratories appeared to provide no input from senior medical/scientific staff into report validation.

Conclusions: These results indicate scope for improvement in the provision of lipid analyses and of information to support their interpretation. We recommend laboratories should routinely provide LDL- and non-HDL-cholesterol results, and that reports should quote treatment thresholds/targets in keeping with current guidelines.