A Survey of Endocrine Function Testing by Clinical Biochemistry Laboratories in the UK

Additional key phrases: thyroid hormones; menopause; gonadotropins; oestradiol; Synacthen test; cortisol; growth hormone;hormonereplace­ ment therapy; adrenocorticotrophin; audit External quality assessment (QA) of analytical accuracy has long been practised by clinical bio­ chemistry laboratories. However, the choice of tests offered to users and the interpretation of results have not been included in the evaluation of labor­ atory performance. The choice of an individual laboratory's test repertoire and protocols for clinical and laboratory investigation is governed by a number of factors including: discussion with clinicians using the service; availability of suitable methods and analytical equipment; and financial considerations. These factors are likely to result in a wide diversity of practice. The aim of this survey was to determine the extent of this diversity. A recent survey of the practice of clinical endo­ crinologists' (Davis and Howlett, in preparation) demonstrated a marked diversity in the inter­ pretation of a number of standard endocrine tests, but did not assess the possible effect of different analytical techniques on data interpretation. Since the profiles of available tests are largely determined by clinical biochemistry laboratories, we have surveyed their pattern of testing and the inter­ pretative guidelines offered to clinicians, parti­ cularly in relation to analytical techniques. METHODS