Sulfobromphthalein Test Increasingly Unnecessary

To the Editor:— A recent survey in our teaching community hospital indicated that about one half the sulfobromphthalein (SBP) tests ordered need not have been done. Increased use of automatic chemical analyzers now permits inexpensive screening of liver function without the risk or inconvenience of the SBP test. In a study conducted at the Englewood (NJ) Hospital, a test "panel" was used to determine values of alkaline phosphatase, serum glutamic oxaloacetic (SGOT) (done by automatic chemical analyzer), thymol turbidity, and direct bilirubin ( done easily by hand). Of 27 patients with abnormal SBP tests, who had such a "liver panel" done, 16 had either (1) a direct bilirubin value greater than 0.25 (in the absence of hemolytic disease) or (2) elevated alkaline phosphatase level (in association with a normal skeletal survey or an elevated SGOT level). In the same study, 19 patients were observed with entirely normal values for direct bilirubin,