Poster Presentation The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2017

Development of a simple method for reporting cortisol and aldosterone results and ratios after  adrenal vein sampling (#220)

Ailie B Connell 1 2 , Alan R McNeil 1
  1. Dorevitch Pathology, Heidelberg, VIC, Australia
  2. Eastern Health Pathology, Greensborough, VIC, Australia

Introduction

Hyperaldosteronism is an important, treatable cause of hypertension which may be caused by unilateral or bilateral disease. Differentiation of these causes requires adrenal vein sampling (AVS) which is invasive and may generate up to 24 specimens. Clear presentation of the results and associated calculations should reduce confusion and the risk of incorrect interpretation.

Methods and Results

Using Microsoft Excel (Microsoft, Redmond WA, USA) we have developed a simple report for AVS incorporating automated calculations that could be adapted to other laboratory reporting systems. The report is created in two parts, firstly, calculation of the necessary ratios to interpret the AVS, secondly, a deceptively simple interpretation provided for confirmation by the clinician.

Conclusions

Adrenal vein sampling creates lab values that require a significantly large post analytical processing to provide a clinically meaning result. Generally, post analytical error contributes to up to 47% of laboratory error, and removing the human error component is an important part of reducing that. Computer aided diagnosis has been shown to improve outcomes and reduce errors. We have developed a robust algorithm based tool to calculate ratios and provide interpretation. The calculator will be available during the poster viewing session for testing and demonstration.