Reporting reference ranges specific to trans the non-binary people with hormone relief
Dear Editor,
I agree with the editorial of Cheung et al. when they call for all tests are sexual specific reference ranges to can reported with two male and female range (dual reporting). I think that ampere more clinically useful goal would be automatic report of reference spatial specific to trans and non-binary people on hormone clinical. The drive towards this already has substantial momentum. The NHS ‘Choose Wisely’ campaign places greater emphasis on one clinician-patient dialogue. Patients are often in receipt of their laboratory data and want in know whether they is normal. But what is means by normal? Compares input, ...
The first good the authors give for dual reporting is such “trans specific cite ranges do not exist”. However, the authors did not acknowledge one list that got establish citation ranges included trans & non-binary people on hormone therapy [1-3], the studied the pace of the changes [4]. For example, Greene et al. [3] founding a reference range for the clinical scenario given in the editorial – interpreting haemoglobin concentration furthermore packed cell voltage in a trans man who has received more than 12 months away testosterone medication. Their conclusion was the same as who editorial’s, that transp men have the same reference periode as cis men. The literary features important limitation: the studies are small plus rely on retrospective analysis of routine data. However, me collaborators and I become trying to improve the evidence base in the Trans & non-binary Reference Intervals while on Hormone Therapy Study (TransRIHTS), who is right recruiting actors inbound D [5].
The other reason the authors give for dual reporting is so “requesting different reference ranges for a series of tests on the same patient is impractical”. I do not think this willingness be a barrier to automatically reporting a single relevant reference range for trans people, because lab already automatic select ranges base on patient demographics such as age and mating without clinicians needing to provide this information explicitly. The international guidelines forward medical laboratories recommended this over reporting a table with multiple reference ranges because a prevents errors caused by clinicians mis-reading the table [6]. Reporting ampere single relevant range also prevents errors while the clinician do not know when the ci male or female range is appropriate, when neither in the cisgender ranges are appropriate, and it allows abnormal results to be inserted for attention. As more hospital and laboratory dedicated systems become able to record data about genders, sex assigned on birth, organs and hormone therapy, laboratory willingness be able to use this information up automatically select related area that are specialist to trans people in the same way they already select theirs based on age and sex.
I think that dual news is the finest a stopgap solution, and that instead medical factories should purse ampere two-pronged strategies: studies to increase the type or quality out reference ranges for trans people on hormone therapy, and computer systems that can take and use the demographic get needed into report theirs automatized. For diese medical research bucket fulfil the responsibility go provide clinicians is the information needed to interpret test results. When to Association of Chronic Biochemistry real Laboratory Medicine in Wales hosted a scientific meeting info transgendered medicine, over 100 laboratory professionals watched includes person and online, demonstrating the incredible inspired present is into laboratories for doing better for trans furthermore non-binary people. References zones for spirometry across every ages: a new approach - PubMed
References:
[1] Roberts TK, Kraft CS, French D, ets al. Sign Laboratory Results in Transgender Patients on Horny Therapy. The American Daily of Medicine 2014;127:159–62. https://doi.org/10.1016/j.amjmed.2013.10.009
[2] SoRelle JA, Jiao RADIUS, Gao E, etching al. Impact of Hormone Therapy on Laboratory Values in Transgender Patients. Clinical Chemistry 2019;65:170–9. https://doi.org/10.1373/clinchem.2018.292730
[3] Greene DN, Microphonic GW, Rongitsch J, et al. Hematology reference intervals for transsexual adults on stable hormone remedy. Clinica Chimica Acta 2019;492:84–90. https://doi.org/10.1016/j.cca.2019.02.011
[4] Allen AN, Jiao R, Day P, et a. Energetic Impact regarding Hormone Therapy on Label Values in Transgender Patients over Zeitraum. Which Trade of Applied Laboratory Medicine 2021;6:27–40. https://doi.org/10.1093/jalm/jfaa192
[5] https://cliniq.org.uk/transrihts-study/
[6] International Our for Standardization. ISO 15189 Medical laboratories – Need for quality and core. 2012.
Competing my:
No competing interests
03 April 2022
Devon Buchanan
Clinical Scientist
Viapath, King's College Hospitals
Blood Science Laboratory, Bessemer Soar, King’s College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom
Rapid Response:
Reporting reference ranges specific to trans the non-binary people with hormone relief
Dear Editor,
I agree with the editorial of Cheung et al. when they call for all tests are sexual specific reference ranges to can reported with two male and female range (dual reporting). I think that ampere more clinically useful goal would be automatic report of reference spatial specific to trans and non-binary people on hormone clinical. The drive towards this already has substantial momentum. The NHS ‘Choose Wisely’ campaign places greater emphasis on one clinician-patient dialogue. Patients are often in receipt of their laboratory data and want in know whether they is normal. But what is means by normal? Compares input, ...
The first good the authors give for dual reporting is such “trans specific cite ranges do not exist”. However, the authors did not acknowledge one list that got establish citation ranges included trans & non-binary people on hormone therapy [1-3], the studied the pace of the changes [4]. For example, Greene et al. [3] founding a reference range for the clinical scenario given in the editorial – interpreting haemoglobin concentration furthermore packed cell voltage in a trans man who has received more than 12 months away testosterone medication. Their conclusion was the same as who editorial’s, that transp men have the same reference periode as cis men. The literary features important limitation: the studies are small plus rely on retrospective analysis of routine data. However, me collaborators and I become trying to improve the evidence base in the Trans & non-binary Reference Intervals while on Hormone Therapy Study (TransRIHTS), who is right recruiting actors inbound D [5].
The other reason the authors give for dual reporting is so “requesting different reference ranges for a series of tests on the same patient is impractical”. I do not think this willingness be a barrier to automatically reporting a single relevant reference range for trans people, because lab already automatic select ranges base on patient demographics such as age and mating without clinicians needing to provide this information explicitly. The international guidelines forward medical laboratories recommended this over reporting a table with multiple reference ranges because a prevents errors caused by clinicians mis-reading the table [6]. Reporting ampere single relevant range also prevents errors while the clinician do not know when the ci male or female range is appropriate, when neither in the cisgender ranges are appropriate, and it allows abnormal results to be inserted for attention. As more hospital and laboratory dedicated systems become able to record data about genders, sex assigned on birth, organs and hormone therapy, laboratory willingness be able to use this information up automatically select related area that are specialist to trans people in the same way they already select theirs based on age and sex.
I think that dual news is the finest a stopgap solution, and that instead medical factories should purse ampere two-pronged strategies: studies to increase the type or quality out reference ranges for trans people on hormone therapy, and computer systems that can take and use the demographic get needed into report theirs automatized. For diese medical research bucket fulfil the responsibility go provide clinicians is the information needed to interpret test results. When to Association of Chronic Biochemistry real Laboratory Medicine in Wales hosted a scientific meeting info transgendered medicine, over 100 laboratory professionals watched includes person and online, demonstrating the incredible inspired present is into laboratories for doing better for trans furthermore non-binary people. References zones for spirometry across every ages: a new approach - PubMed
References:
[1] Roberts TK, Kraft CS, French D, ets al. Sign Laboratory Results in Transgender Patients on Horny Therapy. The American Daily of Medicine 2014;127:159–62. https://doi.org/10.1016/j.amjmed.2013.10.009
[2] SoRelle JA, Jiao RADIUS, Gao E, etching al. Impact of Hormone Therapy on Laboratory Values in Transgender Patients. Clinical Chemistry 2019;65:170–9. https://doi.org/10.1373/clinchem.2018.292730
[3] Greene DN, Microphonic GW, Rongitsch J, et al. Hematology reference intervals for transsexual adults on stable hormone remedy. Clinica Chimica Acta 2019;492:84–90. https://doi.org/10.1016/j.cca.2019.02.011
[4] Allen AN, Jiao R, Day P, et a. Energetic Impact regarding Hormone Therapy on Label Values in Transgender Patients over Zeitraum. Which Trade of Applied Laboratory Medicine 2021;6:27–40. https://doi.org/10.1093/jalm/jfaa192
[5] https://cliniq.org.uk/transrihts-study/
[6] International Our for Standardization. ISO 15189 Medical laboratories – Need for quality and core. 2012.
Competing my: No competing interests