Laboratory Aspects of Clinical Endocrinology (LACE) Special Interest Group

Background

Measurement of hormones is key to the clinical practice of endocrinology. The developments in hormone analysis over the past decades have made diagnosis and management more precise. Yet despite general availability and apparent quality of routine hormone analysis, these assays have failings which are not widely understood. There are issues of specificity and precision, choice of molecular form of peptide hormones, analyte stability and immunoassay interference. Moreover, there are problems of assay standardisation and lack of consensus of units for reporting.

The change in training of both clinical endocrinologists and laboratory scientists is becoming shorter and the opportunities for training in the complimentary disciplines are therefore diminishing. This has the potential for decreased understanding and consequently poorer clinical management.

The next five years pose specific challenges to the long standing relationship between clinical and laboratory medicine in endocrinology.  An NHS commissioning process is set to extend into laboratory medicine.  Furthermore, the developing roles of NICE in patient management pathways means that it is inevitable that diagnostic testing will be taken under the umbrella of evidence-based appraisal in new forms. 

This changing landscape drives the need to review the effectiveness of current structures for engagement.  In particular, the fitness for purpose of separate approaches to areas of mutual interest. 

Aim

This SIG is formed jointly with the Association for Clinical Biochemistry (ACB) and draws members from both the SfE and ACB that include clinicians and scientists with an interest in diagnostics and laboratory methods.  The LACE SIG is convened by Dr Steve Ball (SfE, Newcastle-upon-Tyne) and Dr Julian Barth (ACB, Leeds) who aim to facilitate communication between SIG members and with the two parent Societies.  A committee/steering group will determine the exact remit of the SIG, but the following strategic areas will be considered:

  • To explore the limits of the evidence base for laboratory endocrinology diagnostics
  • To establish a joint forum from which to develop standards and best practice; eg ACB sponsored systematic review of GH tests, see:
    http://www.acb.org.uk/Annclinbiochem/Webwise/jb.pdf
  • To guide the appropriate introduction of new tests into clinical practice - possibly through advice to the Supra-regional Assay Service (SAS)
  • To form a group that can effectively horizon scan for issues of joint interest in the changing clinical and academic landscape
  • To develop a effective vehicle for developing and addressing mutual training issues; leading cross-education
  • To enable effective engagement with national commissioning and appraisal processes across both disciplines

See also...