Women’s Health and Laboratory Testing

Author(s): Christen Diel, Amara Hendricks, Gurmukh Singh

Laboratory testing of body fluids and tissues is an essential part of diagnostic work-up and monitoring for health and healthcare. About 70% of clinical decisions are driven by laboratory data [1,2]. Most of the time laboratory testing is done to screen for a disorder, diagnose or rule out a disorder, monitor the progress of treatment and disease. This narrative addresses the usual laboratory tests that may be done to monitor the health of the person and is not geared towards screening or diagnosis of specific entities. This issue has gained importance since the availability of laboratory results to patients, via patient portals. Patients/lay persons, may over-react to results labeled as abnormal. At the same time patients may not realize the importance of results with a narrative report, e.g., presence of a monoclonal immunoglobulin on serum protein electrophoresis [3,4]. Laboratory testing results usually include a range of normal values, reference range, in laboratory parlance. A reasonable question is, “Where do normal values/reference ranges, come from?” Classically, at least 120 normal, healthy people, of a given age, gender, ethnicity and geographic area, are tested for the chemical/cell type/ analyte under consideration. The lowest 2.5% and highest 2.5% of the results are discarded and the central 95% results are adopted as the reference range/normal value. Under ideal conditions, the specimen is collected in post-absorptive, recumbent state. At one time, metabolic units in academic centers, admitted healthy people who were kept on a prescribed diet and activity. Body fluid, usually blood was collected on waking up for testing to establish normal values [2]. There are a number of issues with the ideal state of specimen collection and what takes place in real life. Some of the issues are addressed below.