{"id":2423,"date":"2015-05-29T16:48:47","date_gmt":"2015-05-29T03:48:47","guid":{"rendered":"http:\/\/microbiologymatters.com\/?p=2423"},"modified":"2015-05-29T16:48:47","modified_gmt":"2015-05-29T03:48:47","slug":"volume-control","status":"publish","type":"post","link":"https:\/\/microbiologymatters.com\/?p=2423","title":{"rendered":"“Volume Control”"},"content":{"rendered":"

Great, you have finally managed to develop that in-house multiplex\u00a0PCR to diagnose disease Y, and thus you can provide the clinicians with a “real-time” result on the same day. Previously you had to send the sample off to a “reference lab”, and a result was not forthcoming for what seemed like an age…<\/span><\/p>\n

Even better, your in-house PCR has primers for an increased number of target pathogens, thus increasing its clinical usefulness. <\/span><\/p>\n

And best of all, its cheaper than the price of the Reference Lab equivalent!<\/span><\/p>\n

Perfect?<\/span><\/p>\n

Hold on a minute. <\/span><\/p>\n

The problem with tests that are better or faster than their predecessors is that they are almost inevitably more popular<\/span>. You may end up with twice the amount of requests than before, obviating any cost savings per individual\u00a0test. You may also find the requests becoming increasingly dubious in their validity.<\/span><\/p>\n

I have seen this happen in practice and it is something that microbiology managers and funders need to be very wary of.<\/span><\/p>\n

How to counteract it? The obvious way is to place appropriate restrictions on test requesting<\/span>. This can either be by insisting on certain clinical conditions being met, or requiring “authorisation” from an expert in the condition before the test request is approved.<\/span><\/p>\n

As the range, speed and quality of microbiology testing improves, I suspect that you are going to see more and more algorhythms, guidelines and evidence based restrictions around test requesting. Indeed I see this as being one of the primary roles of a Clinical\/Medical Microbiologist.<\/span><\/p>\n

and that is the way it should be….<\/span><\/p>\n

Michael<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Great, you have finally managed to develop that in-house multiplex\u00a0PCR to diagnose disease Y, and thus you can provide the clinicians with a “real-time” result on the same day. Previously you had to send the sample off to a “reference lab”, and a result was not forthcoming for what seemed like an age… Even better, … Continue reading “Volume Control”<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[3],"tags":[340,341],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p37jIp-D5","jetpack-related-posts":[{"id":3764,"url":"https:\/\/microbiologymatters.com\/?p=3764","url_meta":{"origin":2423,"position":0},"title":"“We’ll see what we can do…”","author":"michael","date":"April 4, 2018","format":false,"excerpt":"You might be familiar with the following phone calls to the microbiology laboratory: \"I know you only have 0.1ml of CSF left at the lab. Can you still do a viral CSF panel for me?\" \"Although (I swear) the blood culture was from Mr X, the bottles were accidentally labelled\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2018\/04\/eacd5762-5c88-4cee-8347-e455475fe868_1.843529613b6da7e492acc141b620430b-300x300.jpeg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":4052,"url":"https:\/\/microbiologymatters.com\/?p=4052","url_meta":{"origin":2423,"position":1},"title":"“A simple approach to uncomplicated UTI”","author":"michael","date":"January 10, 2023","format":false,"excerpt":"We have a \"no clinical details-no test\" policy at my lab, so in general, we get accompanying clinical details with the vast majority of samples received for microbiology testing. After all, at the end of the day, clinicians just want their requests processed... This is great, but it always irritates\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1399,"url":"https:\/\/microbiologymatters.com\/?p=1399","url_meta":{"origin":2423,"position":2},"title":"“Lumbar Puncture: Creating headaches not only for the patient…”","author":"michael","date":"April 30, 2013","format":false,"excerpt":"25 years ago, examination of cerebro-spinal fluid (CSF) was a fairly straightforward process. You got a cell count, Gram stain, protein and glucose levels. For the really complex patient you might have added a couple more tests like an Indian Ink or a TB culture. Not any more.... There are\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3930,"url":"https:\/\/microbiologymatters.com\/?p=3930","url_meta":{"origin":2423,"position":3},"title":"“Taking the crap out of enteric microbiology”","author":"michael","date":"August 20, 2019","format":false,"excerpt":"Just because a stool sample turns up at your microbiology laboratory, it doesn't mean you have to test it... This is old style microbiology reasoning, testing for everything in the hope that you will find something! There are many different microbiology tests that one can do on a stool sample.\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2019\/08\/PoopEmojiHP-1-300x200.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":4040,"url":"https:\/\/microbiologymatters.com\/?p=4040","url_meta":{"origin":2423,"position":4},"title":"“The impact of COVID on the molecular department of microbiology laboratories”","author":"michael","date":"December 19, 2022","format":false,"excerpt":"COVID has had a profound, and ongoing impact on microbiology laboratories and everyone who works in them. But today I want to write about molecular departments in particular. This department and the staff that work in them have had some momentous experiences and unexpected changes over the last couple of\u2026","rel":"","context":"In "COVID-19"","block_context":{"text":"COVID-19","link":"https:\/\/microbiologymatters.com\/?cat=590"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":3213,"url":"https:\/\/microbiologymatters.com\/?p=3213","url_meta":{"origin":2423,"position":5},"title":"“I told you I was sick”","author":"michael","date":"January 6, 2017","format":false,"excerpt":"Patient: \"I have just come back from Bali\u00a0and I have a fever and joint pains.\" Doctor: \"Not to worry, I think you might have Dengue. I will do a blood test now, and another one in a month's time to see if I am right.\" Patient: \"Just a month, oh,\u2026","rel":"","context":"In "The Science of Microbiology"","block_context":{"text":"The Science of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=4"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2017\/01\/hqdefault-300x225.jpg?resize=350%2C200","width":350,"height":200},"classes":[]}],"_links":{"self":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2423"}],"collection":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2423"}],"version-history":[{"count":1,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2423\/revisions"}],"predecessor-version":[{"id":2424,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=\/wp\/v2\/posts\/2423\/revisions\/2424"}],"wp:attachment":[{"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2423"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2423"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microbiologymatters.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2423"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}