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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, Mauro Panteghini, Sergio Bernardini, Laura Bonfanti, Paolo Carraro, Ivo Casagranda, Mario Cavazza, Ferruccio Ceriotti, Marcello Ciaccio, Daniele Coen, Davide Giavarina, Fabrizio Giostra, Ciro Paolillo, Mario Plebani, Giorgio Ricci, Gianfranco Cervellin
  • 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


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.


Laboratory testing; Urgent testing; Emergency medicine; Consensus document

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Submitted: 2017-01-27 08:41:11
Published: 2017-04-21 17:00:51
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