I've just been told to make an appointment with the nurse following a blood test my Dr requested in relation to Vitamin B12. I asked for a copy and have just recieved this. I expected a positive or negative result in relation to IF test and PC tests but it isn't clear to me what I should be looking for. Can anybody help with the interpretation? Thank you in advance.
[Admin note: Image with results redacted to protect identity of named medical professionals - to be redacted and re-posted]
Wellington1. I've had to delete the image with your blood test results since it contains the names of medical practitioners (identity safeguarding issue and therefore not in line with forum guidelines).
I also note that there are no reference ranges included - these would be required to facility interpretation since different labs use different reference ranges, depending on the testing method and equipment calibration.
Might be easier for you if you obtain lab copies of the actual blood test results rather than a copy of the summary record. The lab test results will also contain appropriate reference ranges for the tests.
You can attach to this post via use of the edit button on the drop down 'more' tab...though you can only attach one image, so may have to manually enter some results (and reference ranges) in the text body. Or, if there is a time lag, you may like to write a new post (older posts slip down the page and may not be spotted so easily by forum members).
👍
Thank you. Apology for not editing properly. I will request the lab copy and re-post.
Apparently the receptionist can't print the lab report with the reference ranges. She has asked whether a clinician might do this. Otherwise I will have to wait for an appointment with the nurse next week and ask her to do it. I had wanted to know and understand a little better the results before the appointment with the nurse though in order that I might ask the right questions. Is it possible to know from the results summary without reference ranges whether the IF test is positive or negative?
When a subject access request is fulfilled, it is necessary for the information to be understandable by the subject.
This means that reference intervals are essential information. If they do not provide them, they have not discharged their duty under the GDPR/Data Protection Act 2018.
Thank you. My Dr surgery has vecome very inaccessible recently.
Thank you for this reply - it helps to take a non emotive stance when you know the facts. Very useful information.
It amazes me at the "computer says No" response from many reception staff and their "think they're God so don't have to bother" attitude towards delivering a service that is actually required of them.
There are, so far as I can understand, two ways in which the Information Commissioner's Office guide identifies that units and reference intervals must be included when medical test results are provided:
First:
The information you provide to people must be concise, transparent, intelligible, easily accessible, and it must use clear and plain language.
ico.org.uk/for-organisation...
A number without units and reference interval is not transparent, intelligible and easily accessible.
Second:
Right to data portability
In order to move data such as test results to another computer environment, units and reference intervals are fundamental necessities.
ico.org.uk/for-organisation...
Please feel free to let me know if you think I am wrong, or if such requirements are identified elsewhere.
Thank you for the extra depth of information - brilliant, as always.
I confess I probably wouldn't even consider that you might be wrong!! I so appreciate your posts and replies: they are always kind, fair and very informative, and, in the absence of my own knowledge, I assume accurate! 😃
You're absolutely right on this one, and porting data from one system to another is fraught with problems. For instance, if your analyses are performed in different laboratories, in different organisations, on different analytical platforms, then there will be different reference intervals [for some very good reasons]. It's confusing at the best of times. It's vital that the reference ranges and units are recognised as being integral with the data. I'd better stop there!
The summary results state that my MCH is high and Lymphocyte is low. Serum B12 is high but thats because I've been having B12 injections every 8 weeks for the last 20 plus years.
Sorry to get a bit technical, but here goes:
It seems as if the 'summary results' aren't much use if they don't give expected ranges! The reference ranges are every bit as important as the analyses themselves. An isolated 'MCH raised' comment is not that helpful. Given that the number of tests performed will have been considerable, and that each one will have a reference range, and those reference ranges will usually be 95% ranges, (mean +/- 2 SD) then (assuming the distribution is Gaussian, which it usually isn't) it's worth remembering that the remaining 5% of normals would be outside the 95% range but inside a 99.7% range, as in (mean +/- 3SD). The more tests we perform, the more likely that some will fall outside the 95% range, whilst still being normal, or insufficiently 'abnormal' to cause any concern.
Once the result is issued by a trained and qualified professional, it can fall into the hands of well-meaning other folks with a lot of experience but lacking the underlying scientific knowledge, who may then misinterpret the results. That's why professionals (scientists) report analyses to other professionals (medics), and the medic can then interpret the result for the patient.
I realise that I've probably unintentionally insulted lots of people on here, and for that, I apologise sincerely. It was not intended, but it simply covers our professional codes of conduct.
I hope this helps!
Thank you all for your really useful insights. This is by far the most intelligent forum I have ever had the the pleasure of being part of. Just one last question, My Dr requested an Intrinsic Factor test and a Parietal Cell test even though I have been having B12 injections for over 20 years. I cannot see anything on the summary that relates to these tests only that they were requested. Should there be a positive or negative result relating specifically to these tests? I've seen other posts that show this. I've never felt the need to ask for blood test results before so not at all sure what I should be expecting. Thank you again.
I should have said that they did my annual blood test at the same time so not sure if the IF and PC tests would be separate and they've just not given them to me.
Hi. The Intrinsic Factor Antibody Test [IFAb] should have a result against it, and be either 'Positive' or 'Negative'. Possibly a number too, although the 'AU' [antibody units] is simply a means of recording how strong the reaction was; it's not [in my opinion, for what it's worth] of particular interest. The 'Pos' or 'Neg' is the interesting bit. However, it can get complicated. Depending on where you are and where the sample goes, then the laboratory may even choose not to perform the test because your B12 result is high, because they may be screening out what they consider to be 'inappropriate requests'. It's highly unlikely that an IFAb result would be affected by a raised serum B12 level, although in some much earlier tests it might have been. [This isn't helpful.] However, the laboratory would [I'm fairly sure; I would have done in my laboratory anyway] agreed to do the test, and done it 'for my attention' to make sure it gets done. It may be necessary for your doctor to contact the lab and discuss it with them, as it may even have been performed. The parietal cell antibody test should have been done regardless, as that is typically done in an Immunology lab as opposed to Haematology or Chemistry.
i hope this isn't too confusing!
Thank you, so helpful and not confusing at all. There was just no mention of these tests on the results summary sheet I was given, just a line at the bottom saying they had been requested. That's the bit that confused me! I was obviously looking for something that wasn't there! Thanks again, I will contact the Drs again!
Hah! Just thought of something. Dependent on the laboratory, they may not do all the tests on the request but they mey be 'send-aways' where they're batched and sent off to some bigger place with bigger workloads, thus avoiding kit wastage. This is because some of the test kits are done in 'Batch Mode' so the test is set up, controls etc run and the samples processed. Other busier places may run the tests in 'Random Access' mode so they come out the same time as the B12 result. Yours just might have been sent off to a reference laboratory. Good luck, it'll all work out in the end.
Thank you once again. I am beginning to think this may be the case. I phoned again today but didn't get any more information. Receptionists really dont have enough knowledge or training or access to records to be dealing with blood test results - not their fault of course! I will get to the bottom of it at some stage.
Wow! Fantastic! Thank you!
I do appreciate that.
If there is a disorder which affects more than 5% of the population, then the reference interval will inevitably include test results which should be outside the reference interval. (Thinking about it very simply.)
Indeed, if there is a disorder which affects just 2.5% of the population, and always in the same direction, then the reference interval will inevitably include test results which should be outside the reference interval.
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Help with blood test results 
