Laboratory testing in the emergency department: an Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and Academy of Emergency Medicine and Care (AcEMC) consensus report

  • Giuseppe Lippi | giuseppe.lippi@univr.it Section of Clinical Biochemistry, University of Verona, Italy.
  • Mauro Panteghini Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan Medical School, Milan, Italy.
  • Sergio Bernardini Department of Experimental Medicine and Surgery, Division of Clinical Biochemistry, University of Rome Tor Vergata, Rome, Italy.
  • Laura Bonfanti Emergency Department, Academic Hospital of Parma, Parma, Italy.
  • Paolo Carraro Department of Laboratory Medicine, ULSS3 Serenissima, Mestre-Venice, Italy.
  • Ivo Casagranda Emergency Department, Santi Antonio e Biagio e Cesare Arrigo General Hospital, Alessandria, Italy.
  • Mario Cavazza Emergency Department, University Hospital S. Orsola-Malpighi, Bologna, Italy.
  • Ferruccio Ceriotti Servizio di Medicina di Laboratorio, Ospedale San Raffaele, Milan, Italy.
  • Marcello Ciaccio Section of Clinical Biochemistry and Clinical Molecular Medicine, Department of Biopathology and Medical Biotechnology, University of Palermo - U.O.C. Laboratory Medicine, Policlinico University Hospital, Palermo, Italy.
  • Daniele Coen Emergency Departement, Niguarda Metropolitan Hospital, Milan, Italy.
  • Davide Giavarina Clinical Laboratory, St. Bortolo Hospital, Vicenza, Italy.
  • Fabrizio Giostra Emergency Department, ASUR Marche Area Vasta 4 Fermo, Italy.
  • Ciro Paolillo Emergency Department, Academic Hospital of Udine, Italy.
  • Mario Plebani Department of Laboratory Medicine, University of Padua, Italy.
  • Giorgio Ricci Emergency Department, University Hospital of Verona, Italy.
  • Gianfranco Cervellin Emergency Department, Academic Hospital of Parma, Parma, Italy.

Abstract

The mainstay of patient-oriented laboratory testing in emergency settings entails selecting number and type of tests according to valid criteria of appropriateness. Since the pattern of urgent tests requesting is variable across different institutions, we designed a joined survey between the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) for reaching tentative consensus about the most informative diagnostic tests in emergency settings. A survey, containing the most commonly performed urgent laboratory tests and the relative clinical indications, was disseminated to eight relevant members of AcEMC and eight relevant members of SIBioC. All contributors were asked to provide numerical scores for the different laboratory parameters, where 1 indicated strongly recommended, 2 recommended in specific circumstances, and 3 strongly discouraged. The mean results of the survey were presented as the mean of responders’ values, and the parameters were finally classified as strongly recommended (mean value, 1.0-1.5), somehow recommended (mean value, 1.5-2.0), discouraged (mean value, 2.0-2.5) and strongly discouraged (mean value, 2.5-3.0). The results of the survey allowed defining a hierarchy of priority, wherein 24 tests were strongly recommended. The use of 5 common tests was instead strongly discouraged. For 16 additional parameters in the list, the consensus ranged between somehow recommended and discouraged. We hope that results presented in this joint AcEMC-SIBioC consensus document may help harmonizing panel of tests and requesting patters in emergency setting, at least at a national level.

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Author Biography

Giuseppe Lippi, Section of Clinical Biochemistry, University of Verona
Emergency Department
Published
2017-04-21
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Issue
Section
Opinion Reports
Supporting Agencies
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Keywords:
Laboratory testing, Urgent testing, Emergency medicine, Consensus document
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  • PDF: 703
How to Cite
Lippi, G., Panteghini, M., Bernardini, S., Bonfanti, L., Carraro, P., Casagranda, I., Cavazza, M., Ceriotti, F., Ciaccio, M., Coen, D., Giavarina, D., Giostra, F., Paolillo, C., Plebani, M., Ricci, G., & Cervellin, G. (2017). Laboratory testing in the emergency department: an Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and Academy of Emergency Medicine and Care (AcEMC) consensus report. Emergency Care Journal, 13(1). https://doi.org/10.4081/ecj.2017.6600

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