What the upper limit of normal for ALT should be, and why it is not
The reference interval for alanine aminotransferase in most laboratories is derived from a population that included people with undiagnosed fatty liver.
Lipids
Page 2 of 3 of this archive, newest first.
Why the recent month counts for half the number
The assay is not the problem. The interpretation of a lagging integral as a current measurement is the problem.
What the outcome trials measured in the kidney
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
Thiamine and the vomiting patient
What the trials measured, which in the case of micronutrients is very little.
Rapid weight loss moves eight analytes for reasons that have nothing to do with the drug
Three different explanations for the same abnormal number, and how to tell them apart.
HbA1c and its lag: what a result three months old is telling you
What the SURPASS and STEP programmes reported, with the estimands and the baseline values stated.
A reference interval is not a target, and a result outside one is not a diagnosis
The arithmetic of the reference change value, worked for the analytes that matter here.
What has to change before a change has happened
A flag is a probability statement about a population. It is not a statement about the person holding the printout.
A guide to the results that will resolve themselves
Three different explanations for the same abnormal number, and how to tell them apart.
Which results are findings and which are consequences of the weight loss
The panel drawn during a week of vomiting is measuring the vomiting.
The reference change value: the number that tells you whether a delta is real
Almost every misreading of a laboratory panel is a misunderstanding of what a reference interval is and how much a result has to move before the movement means anything.
Which results are findings and which are consequences of the weight loss
The estimated glomerular filtration rate is calculated from creatinine, creatinine comes from muscle, and muscle mass is falling. The arithmetic is unforgiving.
The reference change value: the number that tells you whether a delta is real
The arithmetic of the reference change value, worked for the analytes that matter here.
What the upper limit of normal for ALT should be, and why it is not
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
Falling ferritin is not always falling iron
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
What the upper limit of normal for ALT should be, and why it is not
Estimated glomerular filtration rate is a calculation with muscle mass in the denominator of its assumptions. In this population that matters.
The three-times-upper-limit convention, and where it came from
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
Which results are findings and which are consequences of the weight loss
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
The reference change value: the number that tells you whether a delta is real
Almost every misreading of a laboratory panel is a misunderstanding of what a reference interval is and how much a result has to move before the movement means anything.
Reading HbA1c in the presence of anaemia
The alternatives with shorter windows, what they measure, and why they are rarely ordered.