In diagnostic decision-making, clinical laboratory tests (blood tests) are a pivotal part of clinical medicine. The menu of laboratory tests that are available for diagnosis and treatment decision-making has expanded considerably since the 1920s.
The first useful test was devised by Folin and Wu in 1920, the test was used to check the concentration of glucose in serum. The current number of tests which are offered by laboratories include nearly 3,000 analytes, moreover, these analytes do not include thyroid stimulating hormones, glucose TSH, etc., electrolytes, for example, carbon dioxide, chloride, potassium and sodium including complete blood count, CBC. The tests are performed routinely on-site by clinical laboratories or now through Direct Access Testing centers like Test Smartly Labs. In recent years, however, despite the expanding facilities of laboratory testing and tests for diagnosing a number of different diseases that affect mankind, emphasis has been placed on reducing the health care costs. Direct Access Testing (DAT) from companies like Test Smartly Labs, has been an important advancement in giving individuals a choice of their lab test provider and the ability to shop for lab test prices and it turn may reduce overall healthcare costs.
What questions should be asked before ordering a laboratory test?
There are prior considerations, for example, the patient’s medical condition that need to be considered, including an understanding of the appropriate medical tests before ordering any lab testing. For example, what is the reason behind the test being ordered, how efficient is the test for differentiating between health and disease, how will the test results be interpreted and how will the patient management and outcome be influenced with the test results. Answering these questions is important before selecting lab tests, especially for the tests to be cost-effective and for the optimal selection of a test most likely to benefit the patient. A major misconception that is quite prominent among clinicians is that a laboratory test, compared to physical examination and a patient’s history is more objective. In addition to this, it is accepted widely that the use of laboratory tests judiciously including thoughtful interpretation of the results of tests has a significant contribution towards the process of patient management and decision-making. For self-directed lab testing, it is important to share your lab results with your medical professional for treatment or diagnosis of any condition.
What are the reasons for ordering a laboratory test?
There are 4 major reasons for which a laboratory test is ordered, these include diagnosis, for ruling out the diagnosis, monitoring, for example, the effect of the drug therapy, screening (neonatal thyroxine testing for congenital hypothyroidism) and research for understanding the pathology and physiology of any particular disease. There are a few principal approaches that need to be established for diagnosing laboratory test results, for example, deduction of hypothesis, recognition of a pattern, medical algorithms and shotgun versus rifle approach; these are the approaches used for establishing a diagnosis based on the test results of laboratories.
In the process of hypothesis deduction, a differential diagnosis is established based on the history, physical exam findings, drug history, social history, and family history of the patient. The laboratory tests are selected based on this information, moreover, are most likely to confirm and allow the clinician to deduce a diagnosis and list of differential diagnoses. Today, individuals have more access to medical information than ever before, certain tests may be done purely for peace of mind. These tests are available to people in most states without a doctor’s order. This is known as DAT or Direct Access Testing.
Common Lab Test Panels
A grouping of individual lab tests/blood tests designed to help in the identification, analysis, diagnosis and treatment of a disease state or health condition is called a “Panel” or “Profile”. This “bundling” of somewhat similar tests lab testing is called Lab Test Panels or Lab Test Profiles. The individual blood tests are grouped with similar medical conditions in mind. Generally, Test Smartly Labs offers 3-4 levels of progressively more comprehensive lab testing. For instance; a Basic Lab Panel in a specific area of concern like hormones, kidney, thyroid, heart health, cholesterol, diabetes or, and many more, has the “basic” individual blood tests for that health condition. This may be a great starting point is you are looking for “peace of mind” or just want to be reassured that your lab numbers are within a certain range.
Progressively more tests are added as you move up from “Basic” to “Beyond Basics” on the lab test panel options. This allows a more comprehensive view of the blood work to aid in detecting a medical condition or diagnosis. Test Smartly Labs offers a wide range of Individual Blood Tests; as well as, a broad selection of bundled tests we call Lab Test Panels and Profiles.
Complete Blood Count
The test is also known as CBC and is the most common type of blood test that is performed. The purpose of the blood test is to measure the numbers and types of cells present in the blood, the count includes red blood cells, white blood cells and platelets. The test is used for determining the general health of the patient and for screening the patient for disorders, for example, evaluating nutritional status. The test is also used for evaluating symptoms, for example, bruising, fatigue, and weakness and for helping in the diagnosis of conditions such as infection, malaria, leukemia and anemia.
Prothrombin Time
The test is also known as Pro Time or PT, it is used for measuring how long it takes for blood to clot. The coagulation test is for measuring the activity and presence of different types of clothing factors of blood. The test is for screening abnormalities of bleeding and for monitoring treatments via medications and for the prevention of clotting of blood.
Basic Metabolic Panel
The basic metabolic panel test is for measuring creatinine, nitrogen, blood urea, carbon dioxide, chloride, calcium, potassium, sodium and glucose to help in determining the fluid balance, electrolyte balance, blood sugar level and kidney function. The doctor can monitor the effects of the medication that you are taking using the Basic Metabolic Panel, for example, high blood pressure medication can be used for diagnosing certain conditions or can be made a part of routine health screening. The test may require for you to fast for up to 12 weeks.
Beyond Basics Metabolic Panel
Six more tests are combined with the Basic Metabolic Panel in this test for a more comprehensive evaluation of metabolic functions, focusing on organ systems.
Lipid Panel
Lipid panel include a group of tests which are used for evaluating cardiac risks, the tests include testing the levels of cholesterol and triglycerides.
Liver Panel
The liver panel includes a combination of tests which are used for assessing the function of the liver and for establishing a presence of tumors in the liver.
Thyroid Stimulating Hormone
The function of the thyroid is monitored with this lab test screening.
Hemoglobin A1C
The test is used for monitoring and diagnosing diabetes.
Urinalysis
Urinalysis is a general screening test which is often the first lab test performed for checking for early signs of a disease. The test is also used for monitoring kidney disease or diabetes.
Basic Health
Complete Metabolic Panel (CMP)
Complete metabolic panel checks the level of electrolytes, blood glucose, kidney and liver function.
Complete Blood Count (CBC)
The lab test is to check for signs of anemia and for detecting any blood related anomalies; for doing so it checks the various components of blood, for example, red blood cells, white blood cells and platelets.
Glucose
This lab test checks your blood sugar. If the level of sugar in your blood is bolded or marked as high on your form, it may not be abnormal if you were not fasting when the blood was drawn. The normal range of glucose only applies to the fasting samples.
Sexually Transmitted Infection (STI) and Sexually Transmitted Disease (STD)
Chlamydia
The test is used for testing for the presence of chlamydia in the blood. Chlamydia is a sexually transmitted infection present in the cervix, urethra, rectum, throat and urine. The test is commonly done in combination with gonorrhea since the two infections are generally reported together, for example, Ct/GC NAA.
Gonorrhea
The test is used for testing for the presence of gonorrhea, another sexually transmitted disease present in the cervix, urethra, rectum, throat and urine. The test is commonly done in combination with chlamydia since the two infections are generally reported together for example, Ct/GC NAA.
HIV
The test is used for screening for HIV specific antigen and HIV antibodies present, these two are the molecular markers of HIV. Additional confirmatory tests are done in case the test results are positive.
Lyme Disease
The antibody test is performed to aid in the diagnosis of Lyme disease. Lyme disease is a tick born illness which spreads because of the bite of an infected tick. The test is performed in presence of symptoms such as body aches, fatigue and bullseye rash.
Mono
The test is for checking for antibodies which are associated with mononucleosis and are used for aiding in the diagnosis of an active or an acute infection.
QuantiFERON Gold or Tb test
The test is used for the identification of Mycobacterium tuberculosis; the bacteria that causes tuberculosis (TB). TB is an infectious disease that spreads through air borne droplets and cause symptoms, for example, cough, weight loss and night sweats. The test is also used for patients who have previously been exposed to TB or individuals who are at a higher risk of contracting TB. The disease is more common in individuals born outside the US; therefore, this is not a part of the childhood vaccination in the United States.
Rapid Plasma Reagin (RPR)
The test is used for the screening of infection caused by syphilis and for monitoring how effective syphilis treatment is.
Hormone Tests
Cortisol
The test looks at the levels of cortisol which a steroid hormone produced by the adrenal glands. The hormone is associated with many processes of the body and is a major contributor for the fight and flight response that helps in releasing energy in large amounts and short bursts of strength. There are a number of potential endocrine disorders that the high or low levels of cortisol can be associated with.
Estradiol
The test is to check the levels of estrogen, which is the primary female sex hormone. Moreover, estrogen is also present in men at lower levels. This hormone has an impact on the female characteristics of sex, bone health, joint health, fertility, reproductive health and menstruation.
Follicle Stimulating Hormone (FSH)
The test is used for checking the levels of follicle stimulating hormone. The hormone, in women, impacts the production of eggs and the menstrual cycle and varies according to the timing of the menstrual cycle of women. The levels of follicle stimulating hormone in male impacts the production of sperm.
Luteinizing Hormone (LH)
The luteinizing hormone is a hormone that impacts the process of ovulation in women and the production of testosterone in males. This test is used for checking the levels of luteinizing hormone in males and females.
Prolactin
The test is used to check the levels of prolactin; a hormone which is produced in the pituitary gland. The possible issues of the pituitary gland and hypothalamus are evaluated with this test. Furthermore, it is also used for evaluating abnormal milk production outside breast feeding, painful intercourse, visual impairment, headaches, abnormal hair growth, erectile dysfunction and fertility.
Testosterone
The test is used for evaluating the levels of testosterone. Testosterone is a sex hormone which is important for both men and women since it impacts physical characteristics, fertility, reproductive health and sex drive.
Heart Health
Cholesterol (Lipid Panel)
The cholesterol or lipid panel test is used for testing the different components of cholesterol profile. All portions of the profile are added and reflected in total cholesterol. In potential treatment for LDL, there are many considerations, based on individual risk factors and cholesterol values. HDL is a reflects levels of “good” cholesterol and it is generally better if this cholesterol is higher in levels. A component of cholesterol involved in fat storage in liver and blood sugar are triglycerides. If the levels of triglycerides are high there is an increased risk of stroke, heart attack and other health problems. There are more components of the cholesterol panel which are flagged as abnormal based on individual patient risk even if they are completely normal. The bolded results are not concerning necessarily, unless the patient has been told otherwise.
Calcium
Calcium test is used for measuring the level of calcium in blood. Calcium is an important mineral in the body for muscle function, heart and body’s nerve. Furthermore, it is essential for bone formation, maintenance and blood clotting.
Celiac Disease Panel
In case there is a concern that a patient has celiac disease, this test may be ordered. Celiac disease is an autoimmune disease causing an immune response to gluten.