FROM THE EDITOR By Linda Wilson, Senior Edi tor

Publishing information to help guide patient care


edical Laboratory Observer (MLO) has been com- mitted to producing clinical reference tables for laboratories since 1972.

We continue that tradition with the 2021-22 edition of CLR.

Critical limits and reference intervals help labo- ratorians interpret test results. Critical limits estab- lish values that indicate when a patient’s medical condition may be precarious, requiring the immedi- ate attention of the provider who ordered the test. Reference intervals provide clues about test results that may require clinical follow-up to determine if a patient has a disease. It is hard to think of many

decision aids that are more important to patients’ health and well-being. As is the case every year, the editors at MLO would not have been able to produce this year’s CLR issue without help from a roster of external experts. For CLR’s core reference tables, all of which have been updated this

year, we thank the following experts: • Gerald J. Kost, MD, PhD, MS, FACB, of the University of Califor- nia-Davis Health System, for the Table of Critical Limits.

• Allison B. Chambliss, PhD, DABCC, FAACC, Director of Clini- cal Chemistry and Point of Care Testing, LAC and USC Medical Center and Assistant Professor of Clinical Pathology, Keck School of Medicine at USC (University of Southern California) for the Cutoff and Toxicity Levels for Drugs-of-Abuse and Toxicology Testing chart.

• S.T. Campbell, PhD, DABCC, FAACC, Department of Pathology, Mon- tefi ore Medical Center, Bronx, NY, for the Table of Reference Intervals.

• Steven W. Cotton, PhD, DABCC, FAACC, Assistant Professor in Pathology and Laboratory Medicine at the University of North Carolina, Chapel Hill, for the chart on Critical Values for Thera- peutic Drug Levels.

In addition, the author of last year’s special feature on pediatric

reference intervals updated the accompanying charts, which we have published again in the 2021-22 edition. For this work, we thank Maj. Matthew Raines, MD, DABP, Director and Pathologist in the U.S. Air Force. The tables were developed initially to help providers at Joint Base Elmendorf-Richardson Hospital care for their youngest patients. This year’s special feature is on a topic that has consumed us all since early 2020: COVID-19. In the article, the authors from Baylor Scott & White Medical Center – Temple, TX, discuss the impact of variable sensitivity and specifi city in tests to detect SARS-CoV-2 on costs to treat patients with COVID-19. One of the article’s authors, Amin A. Moham- mad, PhD, DABCC, said they produced the research study originally as a teaching tool for residents and students in the MLS program at Texas A&M Health Science Center. We hope our readers will fi nd the article as enlightening as we did. As always, the editors at MLO are open to conversations with

readers about information or suggestions to improve the charts and other content we publish in CLR. Please feel free to reach out to me at


Group Publisher/Executive Editor Kristine Russell

Senior Editor Linda Wilson

Managing Editor Marisa Williams

Graphic Artist Patti Connors

Audience Development/List Rentals Laura Moulton

Ad Traffi c Manager Tiffany Coffman

eProduct Coordinator Mary Haberstroh


East Coast/Midwest Sales (except IL) Classifi ed/Recruitment Advertising Carol Vovcsko (941) 321-2873

South/West Coast/Illinois Sales Lora Harrell (941) 328-3707


John Brunstein, PhD, Biochemistry (Molecular Virology) President & CSO PathoID, Inc., British Columbia, Canada

John A. Gerlach, PhD, D(ABHI) Laboratory Director Michigan State University, East Lansing, MI

Barbara Strain, MA, SM(ASCP), CVAHP Principal, Barbara Strain Consulting LLC Formerly Director, Value Management University of Virginia Health System, Charlottesville, VA

Jeffrey D. Klausner, MD, MPH Professor of Preventive Medicine in the Division of Dis- ease Prevention, Policy and Global Health, Department of Preventive Medicine at University of Southern California Keck School of Medicine.

Susan McQuiston, JD, MT(ASCP), SCy(ASCP) Instructor, Biomedical Laboratory Diagnostics Program Michigan State University, East Lansing, MI

Donna Beasley, DLM(ASCP) Director

Huron Healthcare, Chicago, IL

Anthony Kurec, MS, H(ASCP)DLM Clinical Associate Professor, Emeritus SUNY Upstate Medical University, Syracuse, NY

Suzanne Butch, MLS(ASCP)CM Freelance Consultant, Ann Arbor, MI


Paul R. Eden, Jr., MT(ASCP), PhD Lt. Col., USAF (ret.) (formerly) Chief, Laboratory Services 88th Diagnostics/Therapeutics Squadron Wright-Patterson AFB, OH

Daniel J. Scungio, MT (ASCP), SLS, CQA (ASQ) Consultant at Dan the Lab Safety Man and Safety Offi cer at Sentara Healthcare, Norfolk, VA


CEO Chris Ferrell CFO William Nurthen CRO/CMO June Griffi n

Chief Administrative and Legal Offi cer Tracy Kane COO Patrick Rains

EVP Special Projects Kristine Russell

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(ISSN: 0580-7247). Published monthly, with an additional issue in August, by Endeavor Business Media, LLC., 2477 Stickney Point Rd, Suite 221B, Sarasota, FL 34231 (941) 388-7050. Subscription rates: $127.60/ year in the U.S.; $154.88 Canada/Mexico; Intl. subscriptions are $221.43/year. All issues of MLO are available on microfilm from University Microfi lms International, Box 78, 300 N. Zeeb Rd., Ann Arbor, MI 48106. Current single copies (if available) $15.00 each (U.S); and $20.00 each (Intl.). Back issues (if available) $17.60 each (U.S.); $22.00 each (Intl.). Payment must be made in U.S. funds on a U.S. bank/ branch within the continental U.S. and accompany request. Subscription inquiries: MLO is indexed in the Cumulative Index for Nursing and Allied Health Literature and Lexis-Nexis. MLO Cover/CE, Clinical Issues, and Lab Management features are peer reviewed. Title®

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2 CLR 2021-2022 • MLO • Printed in U.S.A.

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