Clinical biochemistry guidelines in Wales: their impact on laboratory services.

ABSTRACT

BACKGROUND: Evidence of significant variations in clinical biochemistry practice in Wales led to the formation of the All Wales Clinical Biochemistry Audit Group (AWCBAG) in 1993, with the aim of auditing laboratory services to ensure that they are optimally used. As part of this process, clinical guidelines are produced and circulated to all clinical biochemistry departments in Wales. The current aim of the AWCBAG is to assess the extent and impact of adoption of these guidelines across Wales. METHODS: Three surveys were dispatched at intervals over a decade to all clinical biochemistry departments in Wales to investigate practice in (1) urine albumin testing to screen for diabetic nephropathy; (2) biochemical investigation of menopausal status and the monitoring of hormone replacement therapy; (3) screening for Cushing's syndrome. RESULTS: The results show that laboratories across Wales are generally following guideline criteria and are adapting their practice in-line with changing recommendations. CONCLUSION: The introduction of AWCBAG guidelines has been widely accepted by clinical biochemistry departments in Wales. These guidelines have led to a more efficient and effective use of laboratory services.