SW & Wessex Regional Audit Laboratory Investigations of Chronic Diarrhoea

1. SW & Wessex Regional Audit Laboratory Investigations of Chronic Diarrhoea Sue Bird. Clinical Pathology, Dorset County Hospital, DORCHESTER, Dorset Methods Introduction The British Society of Gastroenterology (BSG) recently published guidelines for the investigation of chronic diarrhoea (1). The BSG graded the strength of their recommendations A, B or C according to the category of evidence. These are shown next to the recommendation and are as follows:-A – Requires evidence from at least one randomised controlled trial or a meta-analysis of randomised controlled trials.B – Requires evidence from prospective, retrospective or cross sectional clinical studies without randomisation.C – Evidence based on expert reports or opinion in the absence of directly applicable studies of good quality. A set of 8 standards thought to be appropriate for biochemistry laboratories was developed from the recommendations. A questionnaire was sent to 21 laboratories in the South West and Wessex Regions via the audit leads for the two regions. Results 17/21 labs replied (81%) : 6 teaching hospitals, 11 district general hospitals. Conclusion Hospitals met 5 of the 8 defined standards in the audit. The guidelines (1) and this audit should be helpful to labs still under pressure to carry out 3-day faecal fat analyses. Only one lab in the region was involved in performing breath tests but this may be an area where more help could be offered to gastroenterologists. An invitation to the labs audited to comment on the standards proposed indicated agreement with the standards ( 3 replies). Acknowledgements/Reference Thank you to all the laboratories that took part in the audit and the audit leads Ms Roberta Goodall and Dr Jeremy Quiney. (1) Thomas PD, Forbes A, Green J, et al. Guidelines for the investigation of chronic diarrhoea. 2nd edn. Gut 2003; 52 (Suppl V): v1-15