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Inappropriate lab testing

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https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#1
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28893597/evaluation-of-a-provincial-intervention-to-reduce-redundant-hemoglobin-a1c-testing
#2
Irene Ma, Maggie Guo, Jeannine Viczko, Christopher Naugler
BACKGROUND: The Canadian Diabetes Association recommends testing most individuals with diabetes mellitus using HbA1c once every 3months. In Alberta, Canada, a provincial intervention to reduce inappropriate HbA1c test orders was implemented to align with this guideline, where only one HbA1c test request every 90days for most individuals can be processed. Here, we evaluated the provincial intervention to reduce redundant HbA1c testing in Alberta. METHODS: Total counts of all HbA1c tests ordered within Edmonton and Calgary, Alberta, were collected from the respective Laboratory Information Systems each month between January 2013 and December 2016...
September 8, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28886191/clinical-chemistry-reference-intervals-of-healthy-adult-populations-in-gojjam-zones-of-amhara-national-regional-state-northwest-ethiopia
#3
Zewdie Mekonnen, Asmare Amuamuta, Wondemagegn Mulu, Mulat Yimer, Yohannes Zenebe, Yesuf Adem, Bayeh Abera, Wondemu Gebeyehu, Yakob Gebregziabher
BACKGROUND: Reference interval is crucial for disease screening, diagnosis, monitoring, progression and treatment efficacy. Due to lack of locally derived reference values for the parameters, clinicians use reference intervals derived from western population. But, studies conducted in different African countries have indicated differences between locally and western derived reference values. Different studies also indicated considerable variation in clinical chemistry reference intervals by several variables such as age, sex, geographical location, environment, lifestyle and genetic variation...
2017: PloS One
https://www.readbyqxmd.com/read/28872277/misdiagnosed-hiv-infection-in-pregnant-women-initiating-universal-art-in-south-africa
#4
Nei-Yuan Hsiao, Allison Zerbe, Tamsin K Phillips, Landon Myer, Elaine J Abrams
INTRODUCTION: Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few. METHODS: We examined the accuracy of RDT diagnosis among HIV-infected pregnant women attending public sector antenatal services in Cape Town, South Africa...
August 29, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28858101/usefulness-of-end-tidal-carbon-dioxide-as-an-indicator-of-dehydration-in-pediatric-emergency-departments-a-retrospective-observational-study
#5
Hee Won Yang, Woochan Jeon, Young Gi Min, Ji Sook Lee
Physician assessment of hydration status is one of the most important factors in the management of dehydration in the pediatric emergency department (ED). Overestimating dehydration may lead to overtreatment with intravenous fluids or unnecessary hospitalization, whereas underestimation may lead to delayed therapy and aggravation of symptoms. Various methods to estimate hydration status have been proposed, including use of physical findings, body weight, and laboratory results. These methods are subjective, invasive, or inappropriate for application in the ED...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28834962/artificial-syndrome-of-inappropriate-antidiuresis-model-as-potential-use-for-diagnostic-and-therapeutic-strategies
#6
Julie Refardt, Bettina Winzeler, Fabian Meienberg, Mirjam Christ-Crain
Hyponatremia is the most frequent electrolyte disorder with the syndrome of inappropriate antidiuresis (SIADH) being its predominant cause. Physiological studies in patients with SIADH are difficult to interpret due to usually several comorbidities and polymedication. Therefore, a SIADH model in healthy volunteers would be very helpful to allow insight in this complex disease and to test new therapeutic approaches. The aim of the study was to create a SIADH model with evaluation of subsequent physiological changes...
September 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28833250/how-do-we-perform-and-bill-for-blood-bank-physician-consultative-services
#7
Jeffrey S Jhang, Richard O Francis, Anne Winkler, Christopher Tormey
Transfusion medicine (TM) physicians provide medical services that benefit all patients such as providing 24-hour laboratory coverage, advising health care providers on test interpretation and selection, validating new methods, and supervising technical personnel. These services ensure delivery of accurate, reliable, and timely laboratory test results and blood products. TM physicians also provide consultations to individual patients by 1) interpreting and determining the clinical significance of test results (e...
August 20, 2017: Transfusion
https://www.readbyqxmd.com/read/28831275/beneficiaries-of-conflict-a-qualitative-study-of-people-s-trust-in-the-private-health-care-system-in-mogadishu-somalia
#8
Abdi A Gele, Mohamed Yusuf Ahmed, Prabhjot Kour, Sadiyo Ali Moallim, Abdulwahab Moallim Salad, Bernadette Kumar
BACKGROUND: In 2005, the World Health Conference called for all nations to move toward universal health coverage, which is defined as "access to adequate health care for all at an affordable price". Despite this, an estimated 90% of Somalia's largely impoverished population use private health care. Therefore, considering that the private health care system is the dominant health care system in Mogadishu, Somalia, exploring the accessibility to, as well as people's trust in, the private sector is essential to help contribute an equitable and affordable health care system in the country...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28818586/a-rare-presentation-of-the-syndrome-of-inappropriate-antidiuretic-hormone-in-a-12-year-old-female-as-the-initial-presentation-of-an-immature-ovarian-teratoma
#9
Anoop Mohamed Iqbal, W Frederick Schwenk
BACKGROUND: Immature ovarian teratoma is very rare in childhood. We are reporting 12 yo female with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. CASE: A 12 yo female presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium -123 mmol/L), that did not respond to fluid management. Computerized tomography showed a 15 cm x 9 cm x 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications...
August 14, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#10
Katherine T Forkin, Douglas A Colquhoun, Edward C Nemergut, Julie L Huffmyer
The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging...
August 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28792688/uncritical-request-of-thyroid-laboratory-tests-may-result-in-a-major-societal-economic-burden-results-from-a-large-population-study-in-spain
#11
Maria Salinas, Maite Lopez-Garrigos, Emilio Flores, Carlos Leiva-Salinas
BACKGROUND: Our aim is to study the regional variability in the request of thyroid laboratory tests from primary care facilities in Spain and to investigate a potential inappropriate request and its economic societal impact. METHODS: Spain is divided into 17 autonomous communities (AACCs) which are in turn divided in Health Departments that cover a geographic area and its population and a laboratory that attends the needs of every inhabitant. Each participating laboratory was required to report the number of thyroid tests requested from primary care during year 2014 and to provide organizational data...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28758100/appropriateness-of-tumor-marker-request-a-case-of-study
#12
Massimo Gion, Chiara Trevisiol, Aline S C Fabricio
Appropriateness is crucial to provide efficient and high-quality health services at affordable costs. Laboratory medicine is a sector of special interest for the investigation of inappropriateness, due to the high rate of technological innovation and its pivotal role in many diseases and clinical settings. Some subjective aspects related to either the patient or physician seem to have a major role on inappropriateness rates. Given the psychological impact of cancer on both patients and physicians, tumor markers represent a case of study for appropriateness...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28750423/effectiveness-of-a-laboratory-gate-keeping-strategy-to-overcome-inappropriate-test-utilization-for-the-diagnosis-of-heparin-induced-thrombocytopenia
#13
Janne Cadamuro, Cornelia Mrazek, Helmut Wiedemann, Thomas Klaus Felder, Hannes Oberkofler, Elisabeth Haschke-Becher, Giuseppe Lippi
No abstract text is available yet for this article.
September 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28680353/patient-and-sample-identification-out-of-the-maze
#14
Giuseppe Lippi, Laura Chiozza, Camilla Mattiuzzi, Mario Plebani
Patient and sample misidentification may cause significant harm or discomfort to the patients, especially when incorrect data is used for performing specific healthcare activities. It is hence obvious that efficient and quality care can only start from accurate patient identification. There are many opportunities for misidentification in healthcare and laboratory medicine, including homonymy, incorrect patient registration, reliance on wrong patient data, mistakes in order entry, collection of biological specimens from wrong patients, inappropriate sample labeling and inaccurate entry or erroneous transmission of test results through the laboratory information system...
April 2017: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28679954/errors-in-data-interpretation-from-genetic-variation-of-human-analytes
#15
Heather L Howie, Meghan Delaney, Xiaohong Wang, Lay See Er, Linda Kapp, Jenna N Lebedev, James C Zimring
In recent years, the extent of our vulnerability to misinterpretation due to poorly characterized reagents has become an issue of great concern. Antibody reagents have been identified as a major source of error, contributing to the "reproducibility crisis." In the current report, we define an additional dimension of the crisis; in particular, we define variation of the targets being analyzed. We report that natural variation in the immunoglobulin "constant" region alters the reactivity with commonly used subtype-specific anti-IgG reagents, resulting in cross-reactivity of polyclonal regents with inappropriate targets and blind spots of monoclonal reagents for desired targets...
July 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28676116/metabolic-syndrome-and-its-predictors-in-an-urban-population-in-kenya-a-cross-sectional-study
#16
Geoffrey Omuse, Daniel Maina, Mariza Hoffman, Jane Mwangi, Caroline Wambua, Elizabeth Kagotho, Angela Amayo, Peter Ojwang, Zulfiqarali Premji, Kiyoshi Ichihara, Rajiv Erasmus
BACKGROUND: The metabolic syndrome (MetS) is a clustering of interrelated risk factors which doubles the risk of cardio-vascular disease (CVD) in 5-10 years and increases the risk of type 2 diabetes 5 fold. The identification of modifiable CVD risk factors and predictors of MetS in an otherwise healthy population is necessary in order to identify individuals who may benefit from early interventions. We sought to determine the prevalence of MetS as defined by the harmonized criteria and its predictors in subjectively healthy black Africans from various urban centres in Kenya...
July 4, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28633962/evaluation-of-three-commercial-multiplex-assays-for-the-detection-of-respiratory-viral-infections
#17
Sandi Radko, J Ian Stuart, George Zahariadis
BACKGROUND: Timely identification of respiratory virus infection is essential to mitigate inappropriate antibiotic use and to implement appropriate treatment and/or infection control procedures. As such, multiplexed PCR assays have become standard in many virology laboratories. OBJECTIVES: To compare the Seeplex RV15 (test of record) with two newer generation multiplex assays, the Anyplex II RV16 and the xTAG respiratory virus panels. STUDY DESIGN: Two hundred and three retrospective and 36 prospective respiratory samples were tested by all three assays...
October 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/28633334/knowledge-attitude-and-practice-of-gambian-health-practitioners-towards-antibiotic-prescribing-and-microbiological-testing-a-cross-sectional-survey
#18
Pa Saidou Chaw, Kristin Maria Schlinkmann, Heike Raupach-Rosin, André Karch, Mathias W Pletz, Johannes Huebner, Rafael Mikolajczyk
Background: Inappropriate antibiotic use is the leading cause of antibiotic resistance worldwide. At the same time, the practice of antibiotic prescribing in Africa is less well documented when compared to developed countries. The objective of the study was to assess the knowledge, attitude, and practice (KAP) of health practitioners towards antibiotic prescribing and microbiological testing in The Gambia. Methods: A KAP survey was conducted in The Gambia from March to May 2016...
March 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28574017/line-probe-assay-for-detection-of-mycobacterium-tuberculosis-complex-an-experience-from-central-india
#19
Prabha Desikan, Nikita Panwalkar, Shaina Beg Mirza, Aparna Chaturvedi, Kudsia Ansari, Reeta Varathe, Manju Chourey, Pradeep Kumar, Manoj Pandey
BACKGROUND & OBJECTIVES: Mycobacterium tuberculosis complex may sometimes not be detected in sputum samples of suspected multidrug-resistant tuberculosis (MDR-TB) patients by line probe assay (LPA) even though they are smear positive for acid-fast bacilli (AFB). This retrospective analysis was attempted to understand and document our experience with LPA for detection of M. tuberculosis complex and diagnosis of MDR-TB under programmatic conditions. METHODS: One thousand two hundred and ninety four sputum samples of MDR-TB suspects that were smear positive for AFB, and received from February to November 2013, were tested by LPA for the presence of M...
January 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28572994/experimental-priming-of-independent-and-interdependent-activity-does-not-affect-culturally-variable-psychological-processes
#20
Kesson Magid, Vera Sarkol, Alex Mesoudi
Cultural psychologists have shown that people from Western countries exhibit more independent self-construal and analytic (rule-based) cognition than people from East Asia, who exhibit more interdependent self-construal and holistic (relationship-based) cognition. One explanation for this cross-cultural variation is the ecocultural hypothesis, which links contemporary psychological differences to ancestral differences in subsistence and societal cohesion: Western thinking formed in response to solitary herding, which fostered independence, while East Asian thinking emerged in response to communal rice farming, which fostered interdependence...
May 2017: Royal Society Open Science
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