How should I explain abnormal laboratory results to a patient, including what each test measures, normal reference ranges, the significance and severity of the findings, related conditions, recommended next steps, and warning signs?

How to Explain Abnormal Laboratory Results to Patients

When communicating abnormal laboratory results to patients, begin with a clear, direct statement about whether the result is normal or abnormal, what it means for their health, and what action needs to be taken next—avoiding medical jargon and checking for understanding using the "teach back" method. 1

Prepare Before the Conversation

• Orient yourself to the patient's baseline understanding by asking "What have you been told about these tests?" or "What do you understand about why we ordered these labs?" 1
• Assess the patient's concerns and information preferences by asking "What are you most worried about?" and "What do you want to make sure we discuss today?" 1
• Have a clear action plan ready before presenting results, including next steps for both normal and abnormal findings 1

Structure the Explanation Systematically

Start with a Clear Takeaway Message

• Provide an immediate, unambiguous statement such as "Your kidney function test is abnormal and shows your kidneys are not filtering waste as well as they should" rather than simply stating numbers 2
• Signal whether differences from normal are clinically meaningful by explicitly stating "This difference is significant and requires treatment" versus "This is slightly outside normal but not concerning" 2
• Avoid medical jargon entirely—replace terms like "positive test result," "response rate," or technical terminology with plain language explanations 1

Explain What the Test Measures

• Use simple, concrete language tailored to the patient's educational level: "This test measures how much sugar is in your blood" rather than "This assesses glycemic control" 1
• Provide context about why this measurement matters to their specific health situation, linking it directly to their symptoms or concerns 1

Present the Numbers with Context

• Show the reference range alongside the patient's result and explain what "normal" means for this specific test 1, 2
• Provide thresholds for concern and action by stating specific values: "Normal is below 100, yours is 180, and we start treatment at 150" 2
• Explain that reference ranges describe population averages and may not perfectly apply to every individual, acknowledging biological diversity 3

Clarify Severity and Significance

• Explicitly state the severity level: "This is mildly elevated and we can monitor it" versus "This is severely abnormal and requires immediate treatment" 1
• Connect the result to potential health conditions using plain language: "This pattern suggests your thyroid gland is underactive, which explains your fatigue and weight gain" 1
• Provide a differential diagnosis when appropriate, explaining that several conditions could cause this result and additional testing may clarify which one 1

Address Emotional Responses

• Pause information delivery when patients display strong emotions through verbal or nonverbal behavior, as patients cannot process information effectively when highly emotional 1
• Acknowledge and name the emotions you observe: "You seem worried about what this means" or "I can see this news is distressing" 1
• Use partnership statements such as "I want to work with you to get the best outcome" or "We'll figure this out together" 1
• Ask what concerns them most before providing additional information: "What worries you most about this result?" 1

Communicate Next Steps Clearly

• Provide specific, actionable recommendations including additional confirmatory testing needed, referrals to specialists, treatment options, and timeline for follow-up 1
• Explain why additional testing may be necessary: "This initial test suggests a problem, but we need a more specific test to confirm exactly what's causing it" 1
• State explicitly when urgent action is required versus when monitoring is appropriate 1

Identify Warning Signs

• List specific symptoms that should prompt immediate contact or emergency care: "Call me if you develop chest pain, severe shortness of breath, or confusion" 1
• Provide clear instructions about what to do if warning signs occur, including after-hours contact information 1

Verify Understanding

• Use the "teach back" method by asking "In your own words, what does this result mean?" or "What will you tell your family about what we discussed today?" 1
• Provide information in small doses, stopping frequently to check comprehension rather than overwhelming with information 1
• Avoid information overload by focusing on the most relevant findings and actionable items 1
• Document the discussion in the medical record, including what information was provided and the patient's understanding 1

Provide Supporting Resources

• Offer written materials or educational resources that patients can review at home when they're less anxious 2, 4
• Consider providing a summary letter that restates key points in patient-friendly language 4
• Ensure accessibility by offering materials in the patient's preferred language and format 2
• Assure ongoing availability by stating "I'm available to answer questions as they come up" 1

Critical Pitfalls to Avoid

• Never use ambiguous terminology like "positive" or "negative" without clarification, as patients may misinterpret these terms 1
• Don't assume health literacy even in educated patients—intelligence doesn't guarantee understanding of medical terminology 1
• Avoid providing complex information during emotional distress as patients cannot effectively process it 1
• Don't delay communicating results unnecessarily, as timely information is essential for patient decision-making 1
• Never dismiss patient concerns about results, even if clinically insignificant, as this damages trust and engagement 1

Special Considerations for Specific Result Types

For Genetic or Metabolic Testing

• Reports must be clear to non-specialists and include interpretation of clinical significance, differential diagnosis, and recommendations for confirmatory studies 1
• Provide contact information for the laboratory or metabolic specialists who can answer detailed questions 1
• Recommend referral to specialized centers when new diagnoses are made, as this optimizes patient outcomes 1

For Drug Testing Results

• Discuss results with the patient first before sharing with family members to understand potential explanations for unexpected findings 1
• Explain that false positives occur and confirmatory testing may be needed before drawing conclusions 1
• Frame the conversation around safety rather than accusation when discussing unexpected substances 1