Abstract
The purpose of this book is summed up succinctly by its title – to explain in simple terms the meaning of routine blood tests. The preface to the first edition emphasizes that the text is not intended to be a comprehensive introduction to laboratory investigations but is a guide to the more commonly requested tests, and is aimed specifically at those health-care professionals (e.g. nurses, pharmacists, radiographers, physiotherapists, phlebotomists) who may encounter blood test results in their day-to-day work without having received much formal instruction in their interpretation.
The book is laid out in four major sections: the first two deal with the disciplines of haematology and biochemistry, respectively, with the third briefly covering both disciplines in specific situations of pregnancy and childhood. A very short section on immunological tests is also included here. Each section begins with an introduction and a list of learning objectives and ends with a chapter of case reports, for which the reader is encouraged to make an interpretation of the results presented based on the information they have read in that part of the book. The final part of the book contains five appendices of selected reference ranges, including those applicable in pregnancy and in neonates and children. The author helpfully makes it clear that the quoted ranges should not be applied to data obtained from the reader's own laboratory but are for use only with the cases described in this text.
It is difficult for any author to cover adequately such a huge area as laboratory testing in a small, easy-to-use guide, and though this author makes a good attempt at doing so, some strange choices have been made in terms of layout and content (particularly the third part of the book, which is given the title of ‘Combined Haematology and Biochemistry’ but actually contains information relating to laboratory investigations in pregnancy and childhood, plus a very short and apparently unrelated section on immunology). I found the first part of the book, which deals with haematological investigations, the most useful, though it is very rudimentary in its approach. The biochemistry section tries to cover too much ground and in doing so it failed to be as informative as it could have been about some of the fundamental routine investigations. The case reports (twenty-five in total) are a helpful tool, though, particularly for health-care professionals who may have only occasional exposure to laboratory data.
Although the aims of this book are laudable – it is vital that health-care scientists make every effort to ensure that the results we produce are understood by those who use them – in my view, it does not succeed in its objectives. A major concern is the style in which some of the material is presented, which is at best open to misinterpretation and, at worst, inaccurate. For example, in a section describing the interpretation of oral glucose tolerance tests, we find: ‘One patient's samples may rise rapidly, and exceed the magic 11 mmol/L, but then fall rapidly back into the normal range. Alternatively, another's may rise slowly, never exceed 11 mmol/L but scarcely fall at all’. We may understand what is meant by this, but it is hardly clearly expressed. At the end of the summary section on ‘Water, urea and electrolytes’ there is a sentence that reads: ‘Because the physiology of much of this opening section relies on good kidney function, then this is often presumed, if not demanded. However, this is clearly not always the case and problems with U&Es are often the result of renal disturbances’. I found myself goggling at this passage in an attempt to fathom what the author was trying to say. The text contains many examples of such syntactical and grammatical confusion; indeed, it gives the impression of not having been seriously edited at all. The preface to this, the second edition, specifically states that most of the changes to the text from the first edition were removal of typographical errors – there is still work to do on that front, including, rather ironically, a mistake in this preface itself. These errors must be rectified in any future edition.
It is with regret, therefore, that I am unable to recommend this book to its target readership; I hope that the text of any future editions will benefit from more rigorous editorial input and will therefore be less open to misinterpretation.