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CPE-006 · Scope and validity
HG-VAL-01: Sample timing or illness limits interpretation
Sample timing or illness limits interpretation. Evaluates sample not drawn in the morning (7–10 am) OR acute illness OR recent high-dose biotin.
Condition
- sample not drawn in the morning (7–10 am) OR acute illness OR recent high-dose biotin
What it reports
- Interpretation limited: testosterone varies with time of day and falls in acute illness
Recommended next steps (for physician review)
- Repeat a fasting morning total testosterone before drawing conclusions
Diagnostic boundary
- Does not discard the result; it labels it as provisional.
Evidence
- EV-ES-TRT-2018Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.Supports: Diagnose with symptoms plus unequivocally low testosterone on two morning fasting samples Contraindications and cautions to therapy; monitoring of hematocrit and PSA Evaluation of the type of hypogonadism with LH and FSH
- EV-AUA-2018Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432.Supports: Total testosterone below 300 ng/dL as the threshold; repeat and confirm; fertility counselling before therapy
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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