langcare-lab-interpretation

name: langcare-lab-interpretation description: > Retrieves, organizes, and interprets laboratory results with clinical context including delta checks, abnormal pattern recognition, and drug-lab correlations. Use when asked to interpret labs, review lab results, explain bloodwork, check labs, lab trends, or abnormal labs. Flags critical values requiring immediate action.

Lab Result Interpreter

When to Use This Skill

Use when a clinician needs laboratory results organized by panel, interpreted with clinical context, flagged for abnormals and critical values, and correlated with active medications and conditions.

Clinical Workflow

1. Use fhir_read to retrieve Patient demographics (age, gender for reference range selection)
2. Use fhir_search to pull recent Observation resources (category=laboratory) sorted by date
3. Organize results by panel: CBC, BMP/CMP, liver, lipids, thyroid, coagulation, urinalysis
4. Flag abnormal values using interpretation field and referenceRange; classify as normal, abnormal, or critical
5. Calculate delta checks: pull prior values for each abnormal result, compute absolute and percent change
6. Identify abnormal patterns (e.g., microcytic anemia, hepatocellular injury, cholestatic pattern, anion gap)
7. Use fhir_search to pull active Conditions and MedicationStatements for clinical correlation (drug-lab interactions)
8. Present structured report with trending, pattern analysis, and recommended actions

FHIR Resources

• Observation -- Lab results: code (LOINC), valueQuantity, interpretation, referenceRange, effectiveDateTime, status, component
• Patient -- Age/sex for reference range selection
• Condition -- Clinical correlation with active diagnoses
• MedicationStatement -- Drug-lab interaction correlation

FHIR Query Examples

Pull Recent Labs (30 days)

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&category=laboratory&date=ge[30-days-ago]&_sort=-date&_count=200")

Pull Specific Panel (CBC)

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&code=58410-2&_sort=-date&_count=5")

Pull Prior Values for Delta Check

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&code=[loinc-code]&_sort=-date&_count=5")

Clinical Guidelines

• CAP/CLIA critical value reporting requirements
• KDIGO guidelines for renal function interpretation
• ADA standards for diabetes lab monitoring
• ACC/AHA guidelines for lipid interpretation

Interpretation Guide

• Group by panel and present in tabular format with value, reference range, and interpretation flag
• Significant delta thresholds: Hgb drop >2 g/dL, K+ change >1.0 mEq/L, Cr increase >0.3 mg/dL or >50% (AKI criteria), platelet drop >50% (HIT concern), Na change >8 mEq/L in 24h
• Abnormal patterns: elevated AST+ALT with AST/ALT >2 (alcoholic hepatitis), low MCV + low ferritin (iron deficiency), high MCV + low B12 (megaloblastic anemia), pancytopenia (bone marrow failure workup), elevated anion gap (MUDPILES differential)
• Common drug-lab interactions: metformin + elevated lactate, statins + elevated CK/ALT, ACEi + elevated K+/Cr, warfarin + INR, heparin + platelet drop (HIT)

Safety

• Never fabricate clinical data -- only report what FHIR returns
• Flag critical/abnormal values immediately
• Scope all FHIR queries to the authenticated patient
• Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
• Present data in clinician-friendly format with reference ranges