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SHR Neuro Cancer Cardio Lipid Metab Microb
Mrazek, C; Simundic, AM; Salinas, M; von, Meyer, A; Cornes, M; Bauçà, JM; Nybo, M; Lippi, G; Haschke-Becher, E; Keppel, MH; Oberkofler, H; Felder, TK; Cadamuro, J.
Inappropriate use of laboratory tests: How availability triggers demand - Examples across Europe.
Clin Chim Acta. 2020; 505: 100-107.
Doi: 10.1016/j.cca.2020.02.017
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Keppel Martin Helmut
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- Abstract:
- INTRODUCTION: The appropriate use of laboratory diagnostics is increasingly at stake. The aim of this study was to depict some paradigmatic examples of under- and overutilization, as well as possible solutions across Europe. METHODS: We collected six examples from five European countries where a rise or decline of orders for specific laboratory parameters was observed after organizational changes but without evidence of changes in patient collective characteristics as source of this variation. RESULTS: The collected examples were the following: 1-Germany) Switch from a Brain-Natriuretic-Peptide assay to NT-pro Brain-Natriuretic-Peptide assay, resulting in a 374% increase in these analytics; 2-Spain) Implementation of a gatekeeping strategy in tumor marker diagnostics, resulting in a 15-61% reduction of these diagnostics; 3-Croatia) Stepwise elimination of creatine-kinase-MB assay from the laboratory portfolio; 4-UK) Removal of γ-glutamyl transferase from a "liver function" profile, resulting in 82% reduction of orders; 5-Austria) Implementation of a new device for rapid Influenza-RNA detection, resulting in a 450% increase of Influenza testing; 6-Spain) Insourcing of 1,25-(OH)2-Vitamin D measurements, leading to a 378% increase of these analyses. CONCLUSION: The six paradigmatic examples described in this manuscript show that availability of laboratory resources may considerably catalyze the demand, thus underscoring that inappropriate use of laboratory resources may be commonplace in routine laboratories all across Europe and most probably beyond. They also demonstrate that the application of simple strategies may assist in overcoming this issue. We believe that laboratory specialists need to refocus on the extra-analytical parts of the testing process and engage more in interdisciplinary patient-care.
- Find related publications in this database (using NLM MeSH Indexing)
- Biomarkers, Tumor - analysis
- Clinical Laboratory Techniques - statistics & numerical data
- Creatine Kinase, MB Form - analysis
- Diagnostic Tests, Routine - statistics & numerical data
- Europe - administration & dosage
- Humans - administration & dosage
- Hydroxycholecalciferols - analysis
- Inappropriate Prescribing - statistics & numerical data
- Influenza, Human - blood
- Natriuretic Peptide, Brain - analysis
- Peptide Fragments - analysis
- gamma-Glutamyltransferase - analysis
- Find related publications in this database (Keywords)
- Demand management
- Overuse, Underuse