THE VITAMIN B12 AND FOLATE PATHOLOGY INVESTIGATION
THE INVESTIGATION OF ERRORS IN PATHOLOGY TESTS
FOR VITAMIN B12 AND FOLATE DEFICIENCY
BY MEANS OF MEDICAL EXPERIMENTS
INTRODUCTION
Introduction
What Others Discovered

In 1996, Mounira Khoury, Leslie Burnett and Mark A Mackay reported:

Error rates in Australian pathology laboratories vary widely, but may be as high as 46% for all specimens in some laboratories.
Error rates in Australian chemical pathology laboratories, Khoury et al, MJA 1996; 165: 128-130

In an editorial referring to the above article, in the same issue of MJA, Bryant, reference AA01 commented :

If these findings are extrapolated to all laboratory activity in Australia, errors must abound in alarming numbers.

and

Australian pathology laboratories have been slow to adopt total quality improvement processes.

In their book, Sally M. Pacholok and Jeffrey J. Stuart expose the magnitude of the problem of misdiagnosis of vitamin B12 deficiency. According to Bernard Rimland, PhD, Director, Autism Institute:

Pacholok and Stuart expose a major health-care scandal: the failure to identify and treat hundreds of thousands of patients who suffer from vitamin B12 deficiency.
Could It Be B12? An Epidemic of Misdiagnoses, Linden Publishing; Second edition (January 26, 2011)

According to Oh and Brown:

use of a low serum vitamin B12 level as the sole means of diagnosis may miss up to one half of patients with actual tissue B12 deficiency.
Vitamin B12 Deficiency, Oh and Brown, Am Fam Physician 2003;67:979-86,993-4.

In 2006, S.N. Wickramasinghe reported:

The accuracy of folate assays and particularly of fully-automated red cell folate assays is questionable. The results obtained depend on the assay method -
Diagnosis of megaloblastic anaemias, S.N. Wickramasinghe, Blood Rev. 2006 Nov;20(6):299-318l

In 2007, Chiang et al concluded, in a poster presentation to the AACB reported:

Our study across 3 platforms indicate that many red cell folate results in Auatralia may be incorrect and misleading
Red Cell Folate recovery varies inversely with Haematocrit, C Y Chiang et al
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