What to Ask After Abnormal Test Results

Seeing an “abnormal,” “high,” “low,” “positive,” or flagged result in a patient portal can be unsettling — especially when the result appears before a clinician has explained it. A flag is a signal that a result needs interpretation. It is not, by itself, a diagnosis.

MedlinePlus explains that results outside a laboratory reference range may or may not indicate a health problem, and that clinicians interpret results together with symptoms, medical history, other tests, and the specific laboratory’s reference range.

First ask: what exactly does this test measure?

Before focusing on the number, understand the purpose of the test:

• What does this test measure?
• Why was it ordered?
• What question was the clinician trying to answer?
• Is this result interpreted by itself or together with other values?

Some “panels” contain many individual measurements, and one flagged value may have a very different meaning from an entire pattern of abnormalities.

Ask how far outside the expected range it is

Reference ranges are laboratory-specific and can differ by testing method and patient characteristics. MedlinePlus cautions against comparing your result with a generic range from another source because different labs may use different methods, ranges, and units.

Ask:

• Is this just slightly outside the range or substantially different?
• Has it been abnormal before?
• Is it changing over time?
• Does the trend matter more than this single result?

Ask whether the result fits the rest of the picture

A result is usually interpreted in context. Useful questions include:

• Does this match my symptoms?
• Does it fit my medical history?
• Do other test results support the same explanation?
• Could this be an incidental finding that needs monitoring rather than immediate treatment?

Ask what could temporarily affect the result

Depending on the test, results can be influenced by medicines, supplements, food, hydration, time of day, exercise, illness, stress, or whether test-preparation instructions were followed. MedlinePlus notes that food, medicines, and preparation instructions can affect some laboratory tests.

Do not assume a temporary factor explains the result. Ask whether any of these issues are actually relevant to that specific test.

Ask whether the test should be repeated or confirmed

Some abnormal findings are rechecked before major decisions are made. Others are reliable enough that repeating the same test would add little. Ask:

• Should this test be repeated?
• If so, when?
• Should I use the same laboratory?
• Is a different test needed to confirm or explain the result?
• Would the repeat test require different preparation?

Ask the most important question: how urgent is this?

Do not guess urgency from a red flag in the portal. Ask the clinician:

• Is this something that needs action today?
• Can it wait until a routine appointment?
• Are there symptoms that would make it urgent?
• When should I expect a follow-up call or message?

If you have severe or rapidly worsening symptoms, seek appropriate care based on the symptoms rather than waiting for a portal message.

Ask what happens next

The next step might be no action, monitoring, repeat testing, a new test, medication review, referral, imaging, or an appointment. Write down:

• What needs to happen
• Who orders it
• When it should happen
• How you will receive results
• When to call if you have not heard back

Use the portal carefully

Patient portals can make results available quickly, but the result may arrive before the clinician has had a chance to explain it. MedlinePlus notes that portals can show test results and allow secure messages, but they are not intended for urgent problems.

A useful portal message is concise:

“I saw the result from [test] dated [date]. Could you let me know whether it needs prompt follow-up, whether it should be repeated, and what the next step is?”

A simple result-review worksheet

Sources and further reading

• MedlinePlus: How to Understand Your Lab Results
• MedlinePlus: Laboratory Tests
• MedlinePlus: Patient Portals