Medicine: How Well Do Laboratories Follow Recommendations and Guidelines? The Cardiac Marker Guideline Uptake in Europe (CARMAGUE) Study To the Editor: The original Cardiac Marker Guideline Uptake in Europe

(CARMAGUE) study (1) surveyed laboratory practice against the then current clinical practice recom-mendations (2). The survey was repeated after the publication of the universal definition to see if newer recommendations were be-ing followed (3, 4). An updated version of the questionnaire was implemented as aWeb-based form linked to a database and was tested and validated. Data extraction to a spreadsheet allowed direct tabula-tion of the numbers of responses and combinations of responses for each question. A link to this form was sent via local representatives to a representative sample of labora-tories in each country surveyed. The survey is available on the Web sit