title: Critical review of laboratory investigations in clinical practice guidelines: proposals for the description of investigation.
abstract: BACKGROUND
  Correct information provided by guidelines may reduce laboratory test related errors during the pre-analytical, analytical and post-analytical phase and increase the quality of laboratory results.
  
  
  METHODS
  Twelve clinical practice guidelines were reviewed regarding inclusion of important laboratory investigations. Based on the results and the authors' experience, two checklists were developed: one comprehensive list including topics that authors of guidelines may consider and one consisting of minimal standards that should be covered for all laboratory tests recommended in clinical practice guidelines. The number of topics addressed by the guidelines was related to involvement of laboratory medicine specialists in the guideline development process.
  
  
  RESULTS
  The comprehensive list suggests 33 pre- analytical, 37 analytical and 10 post-analytical items. The mean percentage of topics dealt with by the guidelines was 33% (median 30%, range 17%-55%) and inclusion of a laboratory medicine specialist in the guideline committee significantly increased the number of topics addressed. Information about patient status, biological and analytical interferences and sample handling were scarce in most guidelines even if the inclusion of a laboratory medicine specialist in the development process seemingly led to increased focus on, e.g., sample type, sample handling and analytical variation. Examples underlining the importance of including laboratory items are given.
  
  
  CONCLUSIONS
  Inclusion of laboratory medicine specialist in the guideline development process may increase the focus on important laboratory related items even if this information is usually limited. Two checklists are suggested to help guideline developers to cover all important topics related to laboratory testing.
authors.affiliation: The Norwegian Quality Improvement of Laboratory Services in Primary Care, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. kristin.moberg.aakre@helse-bergen.no
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Aakre
authors.forename: Michel R
authors.initials: MR
authors.lastname: Langlois
authors.forename: Joseph
authors.initials: J
authors.lastname: Watine
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
authors.forename: Hannsjörg
authors.initials: H
authors.lastname: Baum
authors.forename: Paul
authors.initials: P
authors.lastname: Collinson
authors.forename: Païvi
authors.initials: P
authors.lastname: Laitinen
authors.forename: Wytze P
authors.initials: WP
authors.lastname: Oosterhuis
mesh_terms: D006801:Humans; D007753:Laboratories / Q000592:standards* / Q000639:trends*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement