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Lab Reports Pilot - Decision Trees (For your approval)

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These are our first versions, we’ve approved these with the clinical leads at First 4 Health Group You may have some variation in what you consider ‘standard practice’ - would love to hear about it. Feedback will help us serve you better now, but also help us work out what level of configurability is required as we go forward.

✨ New - For your approval

C-reactive protein (CRP)

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Reference

https://www.ncbi.nlm.nih.gov/books/NBK441843/

Text messages

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If normal Your recent CRP blood test (a marker of inflammation) was normal. To learn more visit https://labtestsonline.org.uk/tests/vitamin-b12-and-folate

Urine albumin to creatinine ratio (ACR)

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Reference

https://cks.nice.org.uk/topics/chronic-kidney-disease/diagnosis/initial-investigations/

Text messages

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If normal Your recent urine protein test was normal. To learn more visit https://labtestsonline.org.uk/tests/urine-albumin-creatinine-ratio-or-acr

Vitamin B12

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Reference

https://www.bartshealth.nhs.uk/haematology

Text messages

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If normal (between 180 and 2000) Your recent Vitamin B12 blood test was normal, to learn more visit https://labtestsonline.org.uk/tests/vitamin-b12-and-folate

B-Type Natriuretic Peptide Test (BNP)

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Reference

https://cks.nice.org.uk/topics/heart-failure-chronic/diagnosis/how-to-assess/

Text messages

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If normal (<400) Your recent BNP blood test was normal, to learn more visit https://labtestsonline.org.uk/tests/b-type-natriuretic-peptide-bnp-test

Lipids

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Reference

https://cks.nice.org.uk/topics/lipid-modification-cvd-prevention/management/lipid-therapy-primary-prevention-of-cvd/

Notes

Simple/Normal only for now - advanced lipids including QRISK coming soon! Given the strict guidance around cholesterol it’s unlikely many patients will be considered ‘normal’ by the above algorithm.

Text messages

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If normal (see above) Your recent cholesterol check was normal. To learn more visit https://labtestsonline.org.uk/tests/cholesterol-test

Rheumatoid Factor

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Reference

https://cks.nice.org.uk/topics/rheumatoid-arthritis/diagnosis/investigations-for-suspected-ra/

Text messages

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If normal (less than 20) Your recent rheumatoid factor blood test was normal. To learn more visit https://labtestsonline.org.uk/tests/rheumatoid-factor

⚡ Live Reports

Vitamin D

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Text messages

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If normal Your blood test shows your vitamin D level is normal
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If insufficient Your blood tests show your vitamin D level is slightly reduced. You don't need a prescription but we recommend that you start taking vitamin D tablets at a daily dose of 25mcg (also labelled as 1000iu). You can buy these from any pharmacy.

Notes

  • Under consideration - generate a prescription request to designated pharmacist/clinician.
  • Under consideration - add HIGH vitamin D (>125nmol/L - patient advice)
  • Some guidelines suggest prescription in high risk patients with insufficient vitamin D (25-50) - for now we are not able to support this.

COVID

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Reference

https://cks.nice.org.uk/topics/coronavirus-covid-19/management/confirmed-covid-19/

Text messages

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If positive We’re sorry to hear about your positive COVID test result, if you need advice or information please see https://www.nhs.uk/covid-19-advice-and-services/