Accuracy in clinical chemistry--does anybody care?

The role of clinical chemistry in the diagnostic process has been enhanced by the evolution of better instrumentation and analytical techniques. The quality of some laboratory tests, however, has not kept pace with these advances. I present three examples--serum iron, serum lipase, and nonisotopic immunoassays--assays where some currently used methodologies are highly flawed. Causes for the less than optimal performance of some clinical laboratories are discussed.