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Inappropriate lab testing

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https://www.readbyqxmd.com/read/28795966/the-coagulation-profile-of-end-stage-liver-disease-and-considerations-for-intraoperative-management
#1
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
#2
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
#3
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
#4
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.
July 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28680353/patient-and-sample-identification-out-of-the-maze
#5
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
#6
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
#7
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
#8
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...
June 17, 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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28561878/epidemiology-based-assessment-of-tumor-marker-overordering-in-breast-cancer-an-algorithm-to-examine-different-disease-conditions
#12
Chiara Trevisiol, Massimo Gion, Ruggero Dittadi, Marco Zappa, Aline S C Fabricio
Laboratory tests are frequently overused and have elevated inappropriateness rates. We previously developed a model to investigate the rate of utilization of tumor markers (TMs) in outpatients as an indirect indicator of inappropriateness. The model was based on the comparison between the number of actually ordered and expected tests, with the latter estimated on the basis of both epidemiological data and recommendations of available clinical practice guidelines.In this paper we propose an algorithm to distinguish prevalent cases without evidence of disease from those with metastatic spread, on the basis of both epidemiological and clinical information...
May 23, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28540846/role-of-thromboelastography-in-the-management-of-snake-bite-a-case-report-from-india
#13
Ipsita Nag, Suvro Sankha Datta, Dibyendu De, Partha Pal, Shantanu K Das
In the absence of a specific laboratory test of envenomation, there is a need for an alternative mechanism for the early recognition of envenomation following hematotoxic snake-bite in tropical countries. Abnormalities of clotting are commonly associated with hematotoxic snake bite either due to systemic envenomation or due to the release of an inappropriate tourniquet applied as 'first-aid' often by the rural people before presentation to the hospital. Thromboelastography (TEG) has been used to monitor the coagulation abnormalities in various clinical scenarios...
April 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28521798/use-of-malaria-rdts-in-various-health-contexts-across-sub-saharan-africa-a-systematic-review
#14
Matthew R Boyce, Wendy P O'Meara
BACKGROUND: The World Health Organization recommends parasitological confirmation of malaria prior to treatment. Malaria rapid diagnostic tests (RDTs) represent one diagnostic method that is used in a variety of contexts to overcome limitations of other diagnostic techniques. Malaria RDTs increase the availability and feasibility of accurate diagnosis and may result in improved quality of care. Though RDTs are used in a variety of contexts, no studies have compared how well or effectively RDTs are used across these contexts...
May 18, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28483406/rates-of-inappropriate-laboratory-test-utilization-in-ontario
#15
Nadine Chami, Janet Simons, Arthur Sweetman, Andrew C Don Wauchope
BACKGROUND: Medical laboratory tests ordered redundantly represent one of the targets for reducing diagnostic testing without negatively, and possibly positively, affecting patient care. We study a clearly defined category of excessive laboratory utilization for nine analytes where inappropriate diagnostic testing is defined in terms of the time interval between tests; that is, ordering a test too soon following the previous order of the same test. METHODS: Population data from the near universal public Ontario Health Insurance Plan for the years 2006-2010 are employed where the tests are fulfilled by community medical laboratories...
May 5, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28478722/diagnostic-error-in-pediatric-cancer
#16
Andrea R Carberry, Keith Hanson, Ashley Flannery, Megan Fischer, Jonathan Gehlbach, Carol Diamond, Ellen R Wald
The purpose of this study was to ( a) determine the frequency of diagnostic errors in pediatric cancer, ( b) categorize errors, and ( c) underscore themes associated with misdiagnosis. This is a retrospective cohort study at a tertiary children's hospital of 265 patients with new oncologic diagnoses. The diagnostic error rate was 28%. Compared with those with no diagnostic error, those in whom there was an error were more likely to have ( a) more visits before diagnosis ( P < .001), ( b) not been seen in an acute care setting ( P = ...
May 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#17
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
May 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28474099/a-three-step-diagnosis-of-pediatric-pneumonia-at-the-emergency-department-using-clinical-predictors-c-reactive-protein-and-pneumococcal-pcr
#18
Gabriel Alcoba, Kristina Keitel, Veronica Maspoli, Laurence Lacroix, Sergio Manzano, Mario Gehri, René Tabin, Alain Gervaix, Annick Galetto-Lacour
Recommendations for the management of community-acquired pneumonia (CAP) advocate that, in the absence of the clinical and laboratory findings typical of bacterial CAP, antibiotics are not required. However, the true value of the clinical and laboratory predictors of pediatric CAP still needs to be assessed. This prospective cohort study in three emergency departments enrolled 142 children with radiological pneumonia. Pneumonia with lung consolidation was the primary endpoint; complicated pneumonia (bacteremia, empyema, or pleural effusion) was the secondary endpoint...
June 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28470652/laboratory-diagnostics-of-antiphospholipid-syndrome
#19
Vittorio Pengo, Elisa Bison, Gentian Denas, Seena Padayattil Jose, Giacomo Zoppellaro, Alessandra Banzato
Diagnosis of antiphospholipid syndrome (APS) lies in the recognition of antiphospholipid antibodies (aPL). As standardization of tests for the detection of aPL is far from being optimal and reference material is not available, inappropriate diagnoses of APS are not unusual. In the last few years, the concept of triple test positivity has emerged as a useful tool to identify patients with APS. Clinical studies on patients and carriers of triple positivity clearly show that these individuals are at high risk of thromboembolic events and pregnancy loss...
May 3, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28458798/advances-in-rapid-identification-and-susceptibility-testing-of-bacteria-in-the-clinical-microbiology-laboratory-implications-for-patient-care-and-antimicrobial-stewardship-programs
#20
REVIEW
Florian P Maurer, Martin Christner, Moritz Hentschke, Holger Rohde
Early availability of information on bacterial pathogens and their antimicrobial susceptibility is of key importance for the management of infectious diseases patients. Currently, using traditional approaches, it usually takes at least 48 hours for identification and susceptibility testing of bacterial pathogens. Therefore, the slowness of diagnostic procedures drives prolongation of empiric, potentially inappropriate, antibacterial therapies. Over the last couple of years, the improvement of available techniques (e...
March 30, 2017: Infectious Disease Reports
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