Computer-assisted interpretive reporting with trend analysis of creatine kinase and lactate dehydrogenase isoenzyme determinations

A program has been developed for a central laboratory computer that provides rapid, comprehensive interpretation of CK and LDH isoenzyme determinations. The laboratory computer can receive data on line from a densitometer or by manual result entry from a cathode ray tube. The program algorithm is based on extensive literature references and yields combinations of narrative comments selected from a file of statements. The algorithm is flexible and easily modified; it permits result correlation of simultaneously ordered CK and LDH studies as well as stand-alone interpretation of these tests requested separately. Trend analysis permits identification of changes from previous results and detection of asynchronous appearances of CK-MB and LD-1 as diagnostic of myocardial injury. The output can be formatted to suggest a strategy for further laboratory evaluation of a patient with suspected myocardial injury. Blind sample analysis of 1,500 sets of patient isoenzyme data, comparing human and computer results, has shown that the program is accurate, consistent, and reliable in a variety of clinical circumstances.