MedicinePathologyAnatomic PathologyClinical BiochemistryDiagnostic PathologyGross PathologyTumor MarkersInter-laboratory ComparisonLaboratory Test Result InterpretationPathology-based DiagnosisReference Laboratory StandardsTumor Marker Standardization
The Pathology Harmony initiative is now established nationally and internationally as a driver to take out unwarranted variation in the work of the clinical laboratory. Pathology Harmony was first conceived in Birmingham, UK in 2007. At that time, three major laboratories in the city had procured identical clinical biochemistry analysers. Despite using the same methods for essentially the same population group, these laboratories were using different reference intervals to help interpret results. In most cases the scientific basis justifying these differences was found to be lacking. This led 20 laboratories in the West Midlands and North West Manchester region of England together with all laboratories in Wales to form the Pathology Harmony group, with a remit to examine in detail the variation in reference intervals to see if it could be overcome. In addition, the group identified other areas of pathology that required harmonisation including units of measurement, test names, advice on protocols for simple tests, criteria for telephoning out-of-hours urgent results to primary care, and guidelines for the appropriate use of tumour markers. Here the approaches taken by the UK Pathology Harmony group and examples of the work done are presented to help demonstrate the way harmonisation works, and the potential benefits to service quality and our users.