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Background Evidence of significant variations in clinical biochemistry practice in Wales led to the formation of the All Wales Clinical Biochemistry Audit Group (AWCBAG) in 1993, with the aim of auditing laboratory services to ensure that they are optimally used. As part of this process, clinical guidelines are produced and circulated to all clinical biochemistry departments in Wales. The current aim of the AWCBAG is to assess the extent and impact of adoption of these guidelines across Wales. Methods Three surveys were despatched at intervals over a decade to all clinical biochemistry departments in Wales to investigate practice in: (1) urine albumin testing to screen for diabetic nephropathy; (2) biochemical investigation of menopausal status and the monitoring of hormone replacement therapy; (3) screening for Cushing's syndrome. Results The results show that laboratories across Wales are generally following guideline criteria and are adapting their practice in-line with changing recommendations. Conclusion The introduction of AWCBAG guidelines has been widely accepted by clinical biochemistry departments in Wales. These guidelines have led to a more efficient and effective use of laboratory services.

A commercial method for N-acetyl-β-glucosaminidase (NAG) is described for use on a discrete analyser. Timed overnight urine was obtained from 20 healthy volunteers and 60 Type I diabetic patients for estimation of NAG (expressed in relation to creatinine) and albumin excretion rate (AER). The upper reference limit for NAG excretion in the control patients was found to be 0·25 U/mmol creatinine but was abnormally raised in 60% of Type I diabetic patients before any increase in AER (greater than 20 μg/min), and in 82% of patients with AER greater than 200 μg/min. A positive correlation was found between NAG excretion and AER in Type I diabetes ( r = 0·61, p < 0·01), but not with glycaemic control as measured by serum fructosamine levels. We conclude that measurement of NAG excretion in diabetes indicates renal tubular dysfunction or damage before any significant change in albumin excretion rate.

An abnormal haemoglobin, which on paper electrophoresis has the mobility of Hb J, has been found in two brothers and, in the heterozygous state at least, is not associated with serious clinical abnormality. The structure of this hitherto unreported haemoglobin is α 120 (H3) Ala → Glu and it is named Haemoglobin J Birmingham.