Who would win - a midlevel nurse practitioner with an online MSN-FNP degree from Frontier Nursing University, or a lab result from a CLIA-certified lab? If this example is anything to go by, the answer is certainly the latter. I'm no rheumatologist by any stretch of the imagination, but I certainly remember learning about immunofluorescence speckling patterns in medical school and learning how to properly interpret titers. This Facebook post indicates a fundamental misunderstanding of not only titers and dilution ratios, but the ANA's sensitivity and specificity for autoimmune disease. These are not static parameters - they depend on the dilution factor chosen! In all likelihood, the lab technician running the assay and posting the results wasn't born yesterday. Do you really think that your "understanding of this result" is really going to eclipse the expertise of a clinical lab that does this shit day in and day out? Do you even ROC curve, bro?

For better or for worse, we see non-rheumatology physicians order ANAs all the time to initiate autoimmune disease workups. However, we've never seen a physician publicly soil their dignity by epically misinterpreting a laboratory result that they themselves ordered! Because, you know, it's generally a good rule of thumb to not order lab tests that you don't have any idea how to interpret. Instead of posting on Facebook, it would have been a much better idea to consult a reputable reference or even ask a physician. Having a basic grasp of rheumatology and lab interpretation would be even better! Oh well. I guess they don't cover these sorts of medical fundamentals in the 675 clinical hours at Frontier Nursing University. Maybe you have to upgrade to the Doctor of Nursing Practice (DNP) for that?