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Laboratory Tests and Diagnostic Procedures
2nd ed, edited by Cynthia C. Chernecky, PhD, Barbara J. Berger, MSN, RN, CCRN, 1082 pages, $26.95, ISBN 0-7216-6793-7, Philadelphia, Pa, WB Saunders Co, 1997.
Arch Fam Med. 1998;7:489.
This is the second edition of a book that I had found to be a valuable resource, although, admittedly, I did not use the first edition frequently. However, it was extremely helpful for that occasional question on the name of the now forgotten test or the list of potential causes of a particular abnormality.
The book starts with a table of tests that might be used for various symptoms and diagnoses. I used this to look at the problems of patients I had examined recently and found it to be reasonable but not always complete (eg, angiotensin-converting enzyme inhibitor was not listed under sarcoidosis and urinalysis was not listed under renal cell cancer). This table serves a useful reminder function.
The remainder of the book is an alphabetized listing and description of tests followed by an extensive index. The alphabetization often saves one the step of looking in the index to find a page number. Each test description follows a standardized format including normal ranges, panic level symptoms and treatment, usage, description, professional consideration (eg, whether consent is required, procedure for performing study, etc), and a bibliography. Radiology tests are included. This edition includes more age-specific norms, which are helpful. It is generally well cross-referenced.
This book can be a tremendous resource. Its major fault may well be its lack of sufficient information to easily use some of the individual tests for diagnostic purposes. For example, it lists all of the diseases associated with hypernatremia (under sodium) but provides no algorithm or table of combinations of abnormal findings to help sort through which of the many diseases may be the cause of the hypernatremia. Similarly, the formatting of the material on hepatitis antibodies does not make it easy to figure out the timing of when individual test results should be positive or under what circumstances one would order a certain combination of tests. In general, there is insufficient information about sensitivity and specificity for my taste. Overall, this book serves a useful reference function on laboratory tests but does not provide a strong overview of the use of test combinations.
Marjorie A. Bowman, MD, MPA, Reviewer
Editor
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