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Clinical · Bloodwork · continued

Building a sensible monitoring schedule with your prescriber posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

PP
peak_purityTL3Analytical chemist19 Dec 2024#31

Confirming post #30 from a second method, which matters more than confirming it from a second person.

For anyone finding this later: the short answer on building a sensible monitoring schedule is that it depends on one thing, and the rest of the thread is people identifying which thing.

7 likes 19mo
NS
no.silvaTL219 Dec 2024#32
diluent_watch, post #10: Taking post #7 at face value and following it one step further. Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason. I would put a moderate confidence on that and no more. Go to post

I had written a reply contradicting post #28 and deleted it. Here is what survived.

Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason.

18 likes in reply to #10 19mo
NG
np_gilmoreTL3Nurse practitioner19 Dec 2024#33

Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.

The evidence for this is thinner than the way I have phrased it suggests.

0 likes 19mo
RM
r.mensaTL219 Dec 2024 · edited#34

Before the thread moves on from building a sensible monitoring schedule — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred.

1 like 19mo
MP
mira.patelTL4 Admin19 Dec 2024#35

Appreciated. The plain phrasing does more work here than a longer post would.

12 likes 19mo
CB
c.boatengTL219 Dec 2024#36
v.kjaer, post #7: Checked the building a sensible monitoring schedule claim against the primary source this morning. It survives, with a narrower scope than the version quoted here. Posting the narrower scope. Go to post

Coming back to post #32, because the follow-up matters more than the original answer.

I disagree with the framing of building a sensible monitoring schedule above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.

The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.

25 likes in reply to #7 19mo
OB
owen.bradyTL4 Moderator19 Dec 2024#37
s.vukovic, post #15: A methods point on building a sensible monitoring schedule rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method. Go to post

A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line.

Written from notes rather than memory, which is why the numbers are specific.

0 likes in reply to #15 19mo
SD
s.dialloTL219 Dec 2024#38

Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.

A modest claim, modestly supported.

4 likes 19mo
PM
p.marchettiTL220 Dec 2024 · edited#39

What would change my mind on building a sensible monitoring schedule is a second dataset collected by someone with no stake in the first. Until then I hold it loosely and I would rather say so than pretend to more.

2 likes 19mo
LS
l.solbergTL220 Dec 2024#40

Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason.

The interesting part of this is the exception, and I do not understand the exception.

8 likes 19mo
AH
a.hartmannTL220 Dec 2024#41

Adding a reference point for building a sensible monitoring schedule. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.

13 likes 19mo
EC
excursion_checkTL3Regular20 Dec 2024#42

Adding the measurement that post #41 says would settle it.

Practical answer on building a sensible monitoring schedule, since the theoretical one is upthread: do the simplest check first, write down the result, and only then decide whether the complicated explanation is needed. It usually is not.

4 likes 19mo
BR
b.restrepoTL220 Dec 2024#43
citation_peak, post #26: Reading rather than answering, but this is the post I would point somebody at. Go to post

Where I part company with post #41, and it is a narrow parting.

Glycaemic markers integrate over different periods. A point glucose and a longer-term marker disagreeing is not a contradiction; it is two different questions.

0 likes in reply to #26 19mo
BM
buffer_marginTL3Regular20 Dec 2024#44
n.cabrera, post #17: The arithmetic in post #16 is right; the assumption feeding it is the part to check. A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line. I would want the raw data before agreeing with my own summary of it. Go to post

Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.

I would put this at better than even and not much better.

0 likes in reply to #17 19mo
TA
t.abubakarTL220 Dec 2024#45

I would call the community position on building a sensible monitoring schedule likely rather than established, and I would be comfortable defending that hedge.

8 likes 19mo
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PSkarbekTL3Regular20 Dec 2024 · edited#46

I came in to disagree and I am leaving without a disagreement.

2 likes 19mo
MA
m.achebeTL220 Dec 2024#47

I had written a reply contradicting post #45 and deleted it. Here is what survived.

Summarising the building a sensible monitoring schedule thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length.

0 likes 19mo
VK
v.krastevTL220 Dec 2024#48
dietitian_hollis, post #14: That reframing is the whole thing. The facts I already had. Go to post

Confirming post #45 from a second method, which matters more than confirming it from a second person.

A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line.

26 likes in reply to #14 19mo
TT
t.tullochTL220 Dec 2024#49

If someone has run building a sensible monitoring schedule properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet.

5 likes 19mo
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BBramleyTL3Regular20 Dec 2024#50

Repeat before acting is standard practice for an isolated abnormal result on most analytes, and it is standard for a reason.

A partial answer, offered because a partial answer beats none.

0 likes 19mo
AZ
an.zamoraTL220 Dec 2024#51

Narrowing post #48, because the general version has more than one answer.

Building a sensible monitoring schedule: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.

20 likes 19mo
S
SHermansenTL220 Dec 2024#52
PT
p.trevinoTL220 Dec 2024#53

A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line.

That is the shape of it. The detail is where I would expect to be corrected.

0 likes 19mo
R
RodriguesTL3Regular20 Dec 2024#54

An observation about building a sensible monitoring schedule that I cannot explain and am posting anyway, on the principle that unexplained observations are more useful public than private.

5 likes 19mo
JS
j.sandvikTL220 Dec 2024#55

Adding what did not work for me on building a sensible monitoring schedule, since the failures never get written up and they are half the useful information.

14 likes 19mo
H
HadjipaterasTL1Member20 Dec 2024#56
buffer_margin, post #44: Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same. I would put this at better than even and not much better. Go to post

Time of day: some biomarkers vary across the day. Cortisol in the morning differs from cortisol in the evening. Comparing results from different times of day is comparing things that are not the same.

If anyone can point at the primary source I would be grateful.

28 likes in reply to #44 19mo
YA
y.adeyemiTL220 Dec 2024#57

The documentation on building a sensible monitoring schedule is better than this thread and I say that as someone who has posted in the thread.

0 likes 19mo
AT
a.thorneTL2Wiki editor21 Dec 2024 · edited#58

That is consistent with mine, for whatever one more account is worth.

2 likes 19mo
PL
p.lindqvistTL221 Dec 2024#59
EK
e.kjeldsenTL2Member21 Dec 2024#60
p.trevino, post #53: A trend needs at least three points to be a trend. Two points are a line and a line through noise is still a line. That is the shape of it. The detail is where I would expect to be corrected. Go to post

Glycaemic markers integrate over different periods. A point glucose and a longer-term marker disagreeing is not a contradiction; it is two different questions.

21 likes in reply to #53 19mo