Standardising the biochemical confirmation of adult male hypogonadism: A joint position statement by the Society for Endocrinology and Association of Clinical Biochemistry and Laboratory Medicine

Author:

Jayasena Channa N.1ORCID,de Silva Nipun L.1,O'Reilly Michael W.2ORCID,MacKenzie Finlay3,Marrington Rachel4,Jones Hugh5,Livingston Mark67ORCID,Downie Paul8,Hackett Geoff9,Ramachandran Sud10,Tomlinson Jeremy11,David Janine12,Boot Christopher13,Patel Mayur14,Tarling Julie15,Wu Fredrick16,Quinton Richard17

Affiliation:

1. Department of Metabolism, Digestion and Reproduction Imperial College London UK

2. Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences Dublin Ireland

3. University Hospitals Birmingham NHS Foundation Trust Birmingham UK

4. Birmingham Quality (UK NEQAS) University Hospitals NHS Foundation Trust Birmingham UK

5. Department of Biochemistry, Royal Hallamshire Hospital University of Sheffield Medical School Sheffield UK

6. Department of Clinical Biochemistry, Black Country Pathology Services Walsall Manor Hospital Walsall UK

7. School of Medicine and Clinical Practice, Faculty of Science and Engineering The University of Wolverhampton Wolverhampton UK

8. Department of Clinical Biochemistry Bristol Royal Infirmary Bristol UK

9. Department of Urology Spire Hospital Birmingham UK

10. Department of Clinical Biochemistry University Hospitals Birmingham NHS Foundation Trust Sutton Coldfield UK

11. Oxford Centre for Diabetes, Endocrinology and Metabolism Oxford UK

12. Department of Urology Porthcawl Medical Centre, Princess of Wales Hospital Bridgend UK

13. Department of Blood Sciences Royal Victoria Infirmary Newcastle upon Tyne UK

14. Great Western Hospital NHS Foundation Trust Swindon UK

15. Bedfordshire Hospitals NHS Foundation Trust Bedfordshire UK

16. School of Medical Sciences, Division of Endocrinology, Diabetes and Gastroenterology, Faculty of Biology, Medicine and Health University of Manchester Manchester UK

17. Department of Endocrinology, Diabetes and Metabolism, Newcastle‐upon‐Tyne Hospitals NHS Foundation Trust & Translational & Clinical Research Institute University of Newcastle‐upon‐Tyne UK

Abstract

AbstractBackgroundInter‐assay variation between different immunoassays and different mass spectrometry methods hampers the biochemical confirmation of male hypogonadism. Furthermore, some laboratories utilise assay manufacturer reference ranges that do not necessarily mirror assay performance characteristics, with the lower limit of normality ranging from 4.9 nmol/L to 11 nmol/L. The quality of the normative data underlying commercial immunoassay reference ranges is uncertain.DesignA working group reviewed published evidence and agreed upon standardised reporting guidance to augment total testosterone reports.ResultsEvidence‐based guidance on appropriate blood sampling, clinical action limits, and other major factors likely to affect the interpretation of results are provided.ConclusionsThis article aims to improve the quality of the interpretation of testosterone results by non‐specialist clinicians. It also discusses approaches for assay harmonisation which have been successful in some but not all healthcare systems.

Funder

Society for Endocrinology

Publisher

Wiley

Subject

Endocrinology, Diabetes and Metabolism,Endocrinology

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