ACB Annual National Audit meeting – 24 September 2021

ACB Annual National Audit meeting – 24 September 2021

Dear Editor,

The 2021 National Audit meeting was held virtually for the first time. The programme retained a similar structure to previous meetings. Two national audit presentations were complemented by consultant-level expert opinion. Over 170 delegates registered for the meeting. The audit abstracts received are published as supplementary material to this letter (Supplementary files).

The morning session was primarily dedicated to cystic fibrosis. Dr Sarah Heap, Director of Fetal Anomaly Screening at Birmingham Women’s Hospital presented data from the national audit of sweat testing for the investigation of cystic fibrosis in the United Kingdom. Dr Heap is a member of the guideline development group for the performance of sweat tests. ¹ Dr Maya Desai, consultant respiratory paediatrician at Birmingham Children’s Hospital spoke on sweat testing as well as clinical aspects, diagnosis and recent new therapies for cystic fibrosis. She discussed the application of personalised medicine to cystic fibrosis patients and the use of CFTR modulator therapies – potentiators and correctors – although some therapies combine the two. These new therapies are highly effective and provide sustained improvement in weight, lung function and sweat test results.

Two short presentations of regional audits were given by the authors of the audits. The audit of the use of troponin T in a one-hour pathway for unscheduled care assessment for acute coronary syndrome across sites within the Gloucestershire Hospital NHS Foundation Trust supported the use of this safe and effective risk stratification pathway. ² An audit of xanthochromia requesting in north-east England examined compliance with revised national guidelines ³ and concluded that many requests were unnecessary. Only 13 (0.7%) were diagnosed with subarachnoid haemorrhage (SAH). Conclusions support the draft NICE guidelines ⁴ that if CT head is performed within 6 hours of onset of symptoms and shows no evidence of SAH, then lumbar puncture should not routinely be performed.

Dr Gareth McKeeman, consultant clinical scientist, Belfast Health and Social Care Trust, summarised the findings of the national audit of B type natriuretic peptide (BNP and NT Pro BNP assays). This was followed by clinical perspective on the use of B type natriuretic peptide assays and clinical aspects, assessment and management of heart failure, provided by Prof. Mark Harbinson, consultant cardiologist, Belfast Health and Social Care Trust. He discussed studies which have shown that in some patients with heart failure, suppression of BNP levels (known as BNP-guided therapy) is linked with improved outcomes. Additionally, enhancing levels of active BNP by reducing its metabolism using neutral endopeptidase inhibitors is now being utilised as a novel therapy. The PARADIGM study demonstrated a reduction in heart failure, death and hospitalisation compared to standard treatment; therefore, use of BNP as a therapy may increase soon.

Mr Finlay Mackenzie, UK NEQAS organiser, presented a plan for a forthcoming national audit on thyroid function test reference intervals in pregnancy and neonates, and Mr Jamie West, North West Anglia NHS Foundation Trust, ended the day with the proposed national audit of critical result reporting. This well-attended meeting was highly educational, and feedback from delegates was outstanding.

To read the full meeting report, look out for the write-up in a forthcoming ACB News.

The National Audit committee strives to produce high-quality national audits to inform our community and lead to guideline development. This is only possible by the continuing support of our fellow ACB members who complete the surveys. We thank all of our participants, past, present and future. We welcome new ideas for national audits, so please get in touch.

Supplemental Material

sj-pdf-1-acb-10.1177_00045632211056004 – Supplemental Material for ACB Annual National Audit meeting – 24 September 2021

Supplemental Material, sj-pdf-1-acb-10.1177_00045632211056004 for ACB Annual National Audit meeting – 24 September 2021 by Louise Ward, Wassif Samuel Wassif. Annals of Clinical Biochemistry