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How to prevent unnecessary request prostate-specific antigen testing?

Aim: In this study, it was aimed to show how to limit the unnecessary requests of free prostate-specific antigen (fPSA) test changes with some regulations.Material and Methods: The fPSA requirements when total PSA values below 4 ng/mL or above 10 ng/mL were considered ‘unnecessary test request’. To do this, the relevant physicians were informed and the fPSA test was arranged to have a separate second window on the request panel and physicians were requested only tPSA test requests. An additional fPSA test was conducted by the laboratory staff from patients with a tPSA score of 4-10 ng / mL.Results: It was seen that 1236 fPSA and 1292 tPSA tests (fPSA/tPSA = 95.6%) were performed in our research hospital laboratory between January 17,.2017 and March 09,2017 while 328 fPSA and 1139 tPSA tests were also done between January 17, 2018 and March 09, 2018 (fPSA / tPSA = 28.7%). The ratio of sPSA test request to tPSA test request was found to be reduced by 66.9%.Conclusion: This study limited significant hospital expenditure and labor loss reducing the number of unnecessary fPSA tests with regulations made at the test prompt.

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1. Erasmus RT, Zemlin AE. Clinical audit in the laboratory.J ClinPathol. 2009;62:593-7.
2. Lang T. Laboratory demand management of repetitive testing-time for harmonisation and an evidenced-based approach. ClinChem Lab Med 201351:1139-40.
3. Mohamed Khalifa, Parwaiz Khalid. Reducing unnecessary laboratory testing using health informatics applications: a case study on a tertiary care hospital Procedia Computer Sci 2014:37;253-60.
4. Romero Otero J, Garcia Gomez B, Campos Juanatey F, et al. Prostate cancer biomarkers: an update. Urol Oncol 2014;32:252-60.
5. Benson MC, Whang IS, Pantuck A, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol 1992;147:815-6.
6. Benson MC, Whang IS, Olsson CA, et al. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate-specific antigen. J urol 1992;147:817-21.
7. Bazinet M, Meshref AW, Trudel C, et al Prospective evaluation of prostate-specific antigen density and systematic biopsies for early detection of prostatic carcinoma. Urology 1994;43:44-51.
8. Erol B, Gulpinar MT, Bozdogan G, et al. The cutoff level of free/total prostate-specific antigen (f/t PSA) ratios in the diagnosis of prostate cancer: A validation study on a Turkish patient population in different age categories. Kaohsiung J Med Sci 2014:30:545-50.
9. Green SF. The cost of poor blood specimen qualityand errors in preanalytical processes. Clin Biochem 2013;46:1175-9.
10. Dufour RD. Sources and control of preanalyticalvariation. In: Kaplan AL, PesceJA, Kazmierczak CS. Clinical Chemistry 4th ed. Missouri: Mosby; 2003;64-81.
11. Young SD, Bermes WE, Haverstick D. Preanalytical variables and biological variation. In: Burtis AC, Ashwood RE, Burns AD, eds.Tietz Fundamentals of Clinical Chemistry. Sixth ed. Missouri: Elsevier Saunders; 2008;42-63.
12. Plebani M. Errors in clinical laboratories or errors in laboratory medicine.? Clin Chem Lab Med 2006;44:750-9.
13. Kocatürk E, Canik A, Alataş Ö. Investigation of Unnecessary Laboratory Testing By Using fPSA and Serum Lipids Türk Klin Biyokimya Dergisi 2015;13:101-6.
14. Alsina MJ, Alvarez V, Barba N, et al. Preanalytical quality control program-an overview of results (2001-2005 summary). Clin Chem Lab Med 2008;46:849-54.
15. Kirchner MJ, Funes VA, Adzet CB, et al. Quality indicators and specifications for key processes in clinical laboratories: a preliminary experience. Clin Chem Lab Med 2007;45:672-7.