Lab test interpretation

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Feb 23, 2005
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Dave Taylor
This is for anyone that is in Clinpath, or has an interest for that topic; really, a distant shot in the dark.

Family member has a NA-ProBNT (cardiac indicator) of >1800 (this is sky-high).
Everyone was in a furor, and she raced around to cardiologists the next day.....to find there is nothing abnormal with her heart.

64yrs, no family history of cardiac, doesn't take supplements or illegal drugs. Smoker, some copd. Boring diet, little exercise.

Have read how one type of ProBNT test caused 8 women to have false elevations on NIH, the explanation was elusive.

Wondering if anyone has heard of it; I know we have several in various roles in the medical field here.
Thanks
 
My wife felt ill at work one Monday morning so the museum staff had her go to the hospital. The initial blood tests showed an elevated troponin level so they figure she's had an infarct. An ultrasound and an angiogram later, there's no indication that this has happened. A day after discharge she's back with pains again in a different hospital. This time they properly indentify it as gall bladder.
 
When you start a deep dive on A LOT of these lab tests, you find they are as prone to the same fallacies as everything in society:

1. Not as accurate as advertised
2. Poor quality employees
3. Poor interpretation
4. Risk adversion biased information

What is most interesting to me is how effective they seem to be at keeping victims of bad interpretation isolated from each other.
 
One result does not a trend make…

However, I suppose in an emergency, you might have to base a decision on the data ya got (or wish you had).
 
Repeat the test. Maybe even with a different lab. That is a very high number that needs to be explained. Does she have symptoms? BNP is often elevated with left sided heart problems, but can be elevated also with right sided heart problems, especially in the context of COPD and a myriad of other medical issues. Many cardiologists can overlook right sided heart problems, and echocardiography sometimes gives a very poor look at the right side of the heart. Especially in people with lung disease.
 
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