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Rapid response to:

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Can patients use test results effectively if they have direct access?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h673 (Published 11 February 2015) Cite this as: BMJ 2015;350:h673

Rapid Response:

Re: Can patients use test results effectively if they have direct access?

"I presume you mean a "1 percentage point" change, EG from 7.5% to 8.5%"

And herein lies the crux of the matter. In the UK HbA1c has been reported in mmol/mol since 2009, yet percentage units are still used by clinicians and researchers across the country, in publications, lectures and no doubt in consultation with patients.

Patients do not look at units, they assume (not unreasonably) that units are universal. You just need to look at patient online forums to see patients referring to "their number". The global nature of the internet means that this can be dangerously misleading when American and UK data may be used interchangeably.

I agree that patients with chronic conditions are generally well educated about their condition and in a better position to take ownership of management and that, in certain conditions, direct access to test results could have a positive impact.

"However, imaging results can contain bad news; I would not want patients getting devastating and sometimes speculative results without clinical interpretation." ---- Well laboratory test reports may also contain bad news which, at best, could be described as speculative. Tumour markers are frequently elevated in benign disease and frequently requested inappropriately.

Diagnosis is rarely a straightforward case of interpreting a single test result as low or high. Yes, patients with chronic disease who are motivated to be involved in their management should be encouraged and empowered to do so but diagnostic tests may be best left to those who have taken years of training to understand them.

Competing interests: No competing interests

24 February 2015
Fiona A Davidson
Clinical Scientist
Southmead Hospital