Abstract
This book has a wide target audience from trainees to consultants. It is aimed at those who struggle with mathematics, those who are out of practice and those who may have never been formally taught calculations used in the clinical laboratory. It therefore contains a great deal of basic material in addition to more relevant topics. Something to bear in mind is that this book is written by an American so the book uses US units and terminology throughout, which could cause confusion.
Each chapter has key learning objectives displayed at the start and is divided into three sections: a summary section where key principles are given alongside examples; a question and answer section where the answer is worked through; and finally a section with practice problems, to which the answers are given at the back of the book. Further examples can also be downloaded from the accompanying e-learning website along with teaching material. Access to this is free.
The book layout is designed to give the reader the opportunity to delve in and out of a chapter as required. However, there is a limited use of bold headings or different colour fonts to organize the text in order to facilitate this. The layout could further be improved by highlighting the key equations and principles in bold or within a box and segregating the questions and worked answers more clearly.
The first three chapters cover very basic mathematical principles in detail. The topics discussed include basic arithmetic, rounding numbers, significant figures, scientific notation and logs, systems of measurement and unit conversions. While the cartoon figures used to illustrate the most basic arithmetic rules are unnecessary, the principles discussed serve as a useful reminder if required.
Chapters 4–6 cover common day-to-day calculations experienced in a clinical laboratory. These include performing dilutions, preparing solutions of known concentrations and interconversion of units of concentration. These are some of the most useful chapters in this book for preparing for the FRCPath practical exam or for day-to-day use in the lab. In particular, chapter 6 is full of examples of relevant calculations which can be used for reference.
Chapters 7–12 cover specific calculations experienced in different disciplines, namely clinical chemistry, urinalysis, haematology, immunohaematology (transfusion), microbiology and molecular diagnostics. As the new approach to the UK training of laboratory scientists through modernizing scientific careers unfolds, more of these topics will become relevant to all trainees. These chapters essentially build on the basic principles covered in the first six chapters as applied to specific examples relevant to each area of a clinical laboratory. The topics are very briefly introduced, then followed by examples. The fundamental principles and equations are, confusingly, introduced for the first time in the explanation of worked examples. Disappointingly, these are not emphasized in any way or related back to the basic theory covered in earlier chapters. These chapters also describe the use of historical equipment (refractometers and haematocytometers), but omit problems relating to current practice such as the calculation of fractional excretion of phosphate.
Chapters 13 and 14 cover quality assurance (QA) and quality control (QC) in the clinical laboratory, from basic statistical concepts to use of QC material for monitoring assay performance with Levy–Jennings plots and Westguard rules. These are useful chapters but are unlikely to add anything which cannot be gleaned from practice reviewing one's own laboratory internal QC and external QA data.
The last chapter of the book is entitled ‘Instrument and Method Assessment’. This is a very basic and simplistic view, which lacks detail. The diagnostic value parameters of a test are incomplete. The chapter goes on to detail some statistical calculations of significance, linear regression, recovery, interference and correlation for method evaluation with very few practice examples. These topics are covered elsewhere in a better way.
Trainees reading this review will want to know if this book will help them prepare for the FRCPath wet practical and calculations paper. The recurring theme of this book, which I agree with, is that to master mathematics for the clinical laboratory or otherwise, you need plenty of practice and repetition. The numerous examples provided within this book and on the e-learning website will give you plenty of opportunity to do just that. However, the book does omit important topics and will not prepare you for the style or complexity of question you will be expected to answer in the calculations paper. But if you are struggling with Deacon's challenges, then this book will give you plenty of simpler examples to develop your mathematical skills before attempting those. So, time to dust off your calculators and get practising!