I've known that different labs have different "normal ranges". Why don't we (the U.S.) have STANDARD ranges in this country ! ! ! How about our Canadian friends, are you standardized or other countries???
Example:
Blood from the "same blood draw" date was used with the exception that labcorp didn't process till the next day.
My hospital lab (processed same day) shows adult albumin limits as: 3.5 - 5.0---my result 3.3;
Labcorp (processed next day) shows adult albumin
limits as: 3.2 - 5.6--- my result 3.4
US National Library of Medicine lists adult albumin
limits as: 3.4 - 5.4
others as: 3.2 - 5.0
I noticed this when I looked at the International Staging System (ISS) using "my numbers". I understand the mathematical low impact very well, but the point of it is, the first would show me with hypoalbuminemnia; the second "normal; the US National...with hypoalbuminemnia and borderline hypalbuminemnia; not to mention how such close differences with similar numbers can change the ISS category.
That reminds me of the so called good blood pressure #s. A few years back 130 WAS the gold standard. Now it's 120.
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Re: Do NUMBERS really matter?
I've certainly seen these discrepancies between two different facilities. However, the way one of my docs explained it to me was that there are differences between labs in the way they do the analysis, hence the different acceptable ranges. I've also seen footnotes in one of my lab reports that indicated that one shouldn't correlate the current results with earlier results due to the change in procedure at that particular facility.
So, I don't think the differences are due to different sets of rules that each lab plays by (but maybe that is the case...I'd love to hear other opinions), but more a result of different ranges of values for any given lab that make sense for that given test procedure and equipment.
As I am now charting my numbers pretty carefully over the long run, I've chosen to try to get all my tests at one facility so that I don't have to worry about these differences.
I was also surprised that I got different results from two different labs on one common bone marrow biopsy sample. However, that was explained to me as being due to the fact that plasma cell concentrations can vary in any one area of a single bone marrow sample...which does make sense to me.
So, I don't think the differences are due to different sets of rules that each lab plays by (but maybe that is the case...I'd love to hear other opinions), but more a result of different ranges of values for any given lab that make sense for that given test procedure and equipment.
As I am now charting my numbers pretty carefully over the long run, I've chosen to try to get all my tests at one facility so that I don't have to worry about these differences.
I was also surprised that I got different results from two different labs on one common bone marrow biopsy sample. However, that was explained to me as being due to the fact that plasma cell concentrations can vary in any one area of a single bone marrow sample...which does make sense to me.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Do NUMBERS really matter?
<<< So, I don't think the differences are due to different sets of rules that each lab plays by (but maybe that is the case...I'd love to hear other opinions), but more a result of different ranges of values for any given lab that make sense for that given test procedure and equipment. >>>
Well, different ranges are bad enough and that's all I had noticed before multiple myeloma came looking for me. However, the test results themselves - especially from the IDENTICAL sample- should come out with the same value. If not, I'm missing something or something needs to be changed. The other day, I was saying to my husband, wow, my protein level went down (by .xx) since I left the hospital and now I think I'll better go back and check, because again, one was labcorp and the other the hospital.
Well, different ranges are bad enough and that's all I had noticed before multiple myeloma came looking for me. However, the test results themselves - especially from the IDENTICAL sample- should come out with the same value. If not, I'm missing something or something needs to be changed. The other day, I was saying to my husband, wow, my protein level went down (by .xx) since I left the hospital and now I think I'll better go back and check, because again, one was labcorp and the other the hospital.
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Kate - Name: Kate
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Dec. 2012
Re: Do NUMBERS really matter?
Kate wrote:
> Well, different ranges are bad enough and that's all I had noticed before multiple
> myeloma came looking for me. However, the test results themselves - especially from
> the IDENTICAL sample- should come out with the same value.
Actually, the way I understand it how they do bone marrow plasma cell counting, is they put the sample under a microscope and then manually count the number of abnormal cells that they see relative to normal cells. Since the distribution of the plasma cells isn't perfectly uniform, you will see variations if you examine different areas of the sample (which is unavoidable), and therefore you can see different percentages. Put another way, the same technician working on the same bone marrow sample could come up with two different results by just counting cells in different areas of the sample.
Anyway, I agree it's frustrating.
> Well, different ranges are bad enough and that's all I had noticed before multiple
> myeloma came looking for me. However, the test results themselves - especially from
> the IDENTICAL sample- should come out with the same value.
Actually, the way I understand it how they do bone marrow plasma cell counting, is they put the sample under a microscope and then manually count the number of abnormal cells that they see relative to normal cells. Since the distribution of the plasma cells isn't perfectly uniform, you will see variations if you examine different areas of the sample (which is unavoidable), and therefore you can see different percentages. Put another way, the same technician working on the same bone marrow sample could come up with two different results by just counting cells in different areas of the sample.
Anyway, I agree it's frustrating.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Do NUMBERS really matter?
A similar posting regarding this subject is available here in a thread titled " The ISS and Serum Albumin Tests"
https://myelomabeacon.org/forum/the-iss-and-serum-albumin-tests-t748.html
with a response from Dr. Voorhees.
There is a differance between protocols and lab equipment when testing for albumin levels such as Lipid Panels at local hospitals. There is also a complete differance in procedure when testing with SPEP. Hope this helps.
Billy1
https://myelomabeacon.org/forum/the-iss-and-serum-albumin-tests-t748.html
with a response from Dr. Voorhees.
There is a differance between protocols and lab equipment when testing for albumin levels such as Lipid Panels at local hospitals. There is also a complete differance in procedure when testing with SPEP. Hope this helps.
Billy1
Re: Do NUMBERS really matter?
I was told that there are too many variables affecting lab tests for them to be exactly the same all the time which is why they give the reference ranges. If I understood what I was told, everything from the age of the machine doing the testing, and the last time it was serviced, to the technician performing the test can affect the outcome. The reference ranges are given as a way to account for those variables and are specific to each laboratory. For most blood work, being a little outside the lab's normal range isn't that big of a deal. For myeloma the most important thing is trend over time. The one caveat being when you see a huge change in a number between two tests. In that case, you should have it repeated to see if there was a "lab error."
Lyn
Lyn
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Christa's Mom - Name: Christa's Mom
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: September, 2010
- Age at diagnosis: 53
Re: Do NUMBERS really matter?
This discussion is why nobody should focus on any one test. The focus should be on trends from a series of tests. Assuming that your oncologist uses the same lab, the series would be a much stronger indicator of where things are or are going.
Ron
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Do NUMBERS really matter?
Hi Christa's Mom,
>> For most blood work, being a little outside the lab's normal range isn't that big of a deal>>
I was thinking the same way BUT it can be a huge big deal.
That's how multiple myeloma was KINDLY overlooked for almost 2 years in my case. The blood test showed a small rise in protein and then it was just a "tiny bit" outside the lab's normal range. And voila, here I am, albeit late.
Kate
>> For most blood work, being a little outside the lab's normal range isn't that big of a deal>>
I was thinking the same way BUT it can be a huge big deal.
That's how multiple myeloma was KINDLY overlooked for almost 2 years in my case. The blood test showed a small rise in protein and then it was just a "tiny bit" outside the lab's normal range. And voila, here I am, albeit late.
Kate
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Kate - Name: Kate
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Dec. 2012
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