Understanding laboratory results

When your doctor orders a laboratory test for you, it is for the purpose of understanding your health situation better after a preliminary history taking and physical examination. It takes into account your past medical history (your previous illnesses as well as your risk factors) and your current signs and symptoms. Laboratory tests are objective evidence of the presence or absence of diseases or predisposition to illnesses which can be minimized by proper lifestyle or medical interventions.

Hence, your attending physician is the best person to interpret your laboratory results. Although the lab results are objective, they must be interpreted in the light of the patient’s health status. That is why, in most countries, laboratory results are only sent to the doctor who ordered the test so that he/she can properly evaluate it and discuss it with the patient.

In the Philippines, it has been the practice to give the patient his/her laboratory results regardless of the person’s doctor having seen it first. Many claim it is the patient’s right to see the results since he/she paid for it. But that’s only half the story. Often, the patient has no idea of how to interpret the results other than to see that there is an H (high) or L (low) beside the values for the tests. He may not even know what the test is for. As a result, some may feel fear or panic based on seeing abnormal results without having any inkling on what the test is for. That, to me, is patently unfair and unkind to the patient. The patient deserves better by having the result sent to his/her doctor who will tell the patient what’s wrong by correlating what the doctor knows about the patient’s condition with the laboratory results.

There may be a few instances where the doctor may not see any problem with the patient with regards to, say, a heart condition, but the lab result is abnormal. The doctor may dig further into the patient’s history which may not have been divulged by the patient. If there is absolutely no correlation of the lab result with the patient’s condition, he may order a repeat test to double check the result.

The repeat test may confirm the previous result, in which case, the physician will more intensively check the patient for subtle signs of disease that may not have been apparent on earlier examination. Alternatively, there may have been a problem with the lab test since human errors do occur in the best of laboratories as is the case in all human endeavors.

The public seems to demand perfection in all medical examinations, physical, laboratory, or imaging as in x-rays, CT scans or ultrasounds. We do exert all efforts to be as accurate as possible in the health care system. Quality systems are now in place in all reputable hospitals and clinics, spurred on by past history of unnecessary medical interventions due to errors in diagnosis or lab exams. We do delta checks, meaning we correlate the previous results of a patient with the current results to make sure we’re not dealing with a misplaced decimal point or even an interchange of values between patients. With critical values, which are results that are alarming and may be life threatening, the result is double checked by another staff and may be repeated to ensure accuracy. There is a culture of quality now in place to minimize errors. Unfortunately, no matter how we try, human errors will happen, due to fatigue, distraction or other human failings. But these are fortunately few and far between.

So, it is important that your doctor interprets your lab results. Don’t go over it yourself unless you want to give yourself sleepless nights or even a heart attack. We’ve read of certain cases that ended with the patient committing suicide thinking he’s a hopeless case when it’s not.

The opposite also happens a lot more. When a person is in denial, he will ignore his result as a lab error. That may lead to worsening of his disease to the point where medical intervention will no longer be effective. Had he consulted a doctor, he may have prevented worsening of the illness. Majority feel it is too expensive to seek medical consultation and may resort to “organic” self remedies, or consult a “hilot’, “arbulario” or other quacks. End result is that he may be directly harmed by these “healers” treatment or since they are ineffective, his medical condition will worsen to a late stage where modern medicine cannot do anything for him.

Bottomline: Don’t self diagnose just as you shouldn’t self-medicate.  Both can be very harmful.