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The report of the medical laboratory is the final result of the complex analytical activity that requires technology, automation, organization and competence. The content of the report has been defined since 2015, but the application of the legislative requirements is still incomplete. The need for interoperability of the medical laboratory reports in order to be easily accessible and understandable throughout Europe, increases the requirements for the development of standards for reporting of test names, units of measurement, qualitative expressions. The adoption of LOINC codes may improve interoperability, but the codes have to be used correctly and a stewardship from Scientific Societies is needed. The laboratory reports are moving from paper to electronic format, and this should help the readability and simplicity favoring the interpretation, but the increasing amount of data and information may make them more difficult to read. This aspect together with the rapid development of new analytical technologies increases the need for interpretative comments, that should be clear, avoid acronyms or excessive technical terms and tackle the real relevant aspects. Being the final product of our activity, the report deserves more attention from our profession. [ABSTRACT FROM AUTHOR]

Urine albumin is a well-known biomarker of proven clinical utility for relevant pathological conditions and a risk factor for cardiovascular mortality. This paper is aimed to illustrate the state-of-art of albuminuria measurement and the adherence to the official recommendations in scientific writing. In spite of the urine albumin clinical importance, the standardisation of the analyte is not completed yet, but the adoption of decisional values (established in 2013) would require standardized methods to allow the correct classification of patients. The Italian EQA scheme for albuminuria shows variable bias to the consensus value, depending on the analytical system: a typical situation originating from the lack of international standardisation. The harmonisation of the measure is more advanced: the EQA data show that 74% of participants use the albumin/creatinine ratio to report the urine albumin excretion. A recent systematic review examined how the albuminuria data are reported in clinical studies. A sub-optimal situation is illustrated: the laboratory information is often lacking or incorrectly reported. The obsolete term "microalbuminuria" is used in >40% of the studies, only 20% of the studies uses the correct sample (first morning void). The data about the post-analytical are more encouraging: the measurement units and the decisional values are correctly reported in the majority of the studies. The correction of this situation, that makes it difficult to transfer the results from clinical studies to the daily practice, requires a stringent collaboration between laboratory professionals and clinicians: working together in multidisciplinary groups to understand the respective needs is to be promoted. [ABSTRACT FROM AUTHOR]

Introduction: the Coordination Regional Center for Laboratory Medicine of Lombardy Region provides the External Quality Assessment (EQA) scheme of urine particle evaluation with the aim to verify the inter-laboratory reproducibility of the morphological identification of urine particles. In 2022 we evaluated the concordance between the results obtained testing the same images proposed in two different exercises. Methods: the EQA material consisted of digitalized images of two urine sediments (Case 1 and Case 2) in phase contrast microscopy, where the recognition of the most relevant elements (maximun 4) and the correlation to a clinical condition were requested. To each correct recognition a score of 1 was assigned. Results: in the image of Case 1 leukocytes, bacteria, isomorphic red blood cells and aggregated leukocytes, the typical elements of a urinary tract infection, were recognizable. In the image of Case 2 leukocytes, dysmorphic red blood cells and acanthocytes, the typical elements in a haematuria condition in glomerulonephritis, were recognizable. The percentage of recognition incresead from the first to the second exercise in both the Cases, although few laboratories obtained a full score and many laboratories did not recognized the most common elements frequently present in a urine sediment. Discussion: this EQA scheme was very helpful to verify and strengthen basic skills for the recognition of urinary sediment particles in order to support the clinical decision-making process, although there is some work to be done in order to improve the skills of the operators and the culture of quality in this specific field of laboratory medicine. [ABSTRACT FROM AUTHOR]