Is This a Critical, Panic, Alarm, Urgent, or Markedly Abnormal Result?

To the Editor:Medical laboratories often produce clinically unexpected results that require timely clinical evaluation because they herald an imminent life-threatening condition or major clinical deterioration. Laboratories therefore need to proactively identify and report such results sooner than would routinely occur, and have policies and procedures that minimize the possibility of patient harm due to delayed clinical awareness.Since Lundberg's first description of so-called panic values (1), a variety of other terms have appeared in the literature, for example: urgent, critical, acute, alert, emergent, abnormal, markedly or significantly abnormal, clinically significant, vital, red-orange-yellow zone values, and various combinations thereof. Most of these definitions are reworded alternatives of Lundberg's original description (2, 3). Two recent literature reviews emphasize the need for an agreed terminology to assist global harmonization of the laboratory management of such test results (4, 5).Current definitions focus on the degree of result abnormality, timeliness of communication, and likely patient outcomes (e.g., mortality, morbidity) rather than on the risk to patient safety. Although it is true that unexpected …