Inappropriate requests of viral hepatitis serologic tests

Amaç: Laboratuvar testlerinin uygunsuz ve aşırı istemi ciddi bir iş yükü ve maliyete neden olmaktadır. Gereksiz ve fazla test kullanımını önlemek için çeşitli tanısal algorit- malar önerilmektedir. Bu çalışmada tanısal algoritmalara göre hepatit serolojisinde uygunsuz test istemlerinin oranı ve getirdiği mali yükün belirlenmesi amaçlanmıştır. Gereç ve yöntem: Uygunsuz test istemlerinin sayısının belirlenmesi için hepatit A ve B viral serolojik testleri viral hepatit tanısında kullanılan serolojik tanısal algoritmalara göre retrospektif olarak değerlendirilmiştir. Hepatit A ve B tanısında kullanılan testlerden hastanın klinik durumunu ortaya koyacak şekilde yapılan test istemleri çalışmaya dahil edilmiş, hastalığın klinik evresi ile ilgili yetersiz test istemi nedeniyle bilgi edinilemeyen testler çalışmadan çı- karılmıştır. Bulgular: Tanısal algoritmalara gore; 1452 anti-HAV IgM testinin, 1452 anti-HAV total testinin, 208 anti-HBs testinin, 208 anti-HBc total testinin, 1210 anti-HBc IgM testinin, 1358 HBeAg testinin, 1216 anti-HBe testinin uy- gunsuz istem olduğu belirlenmiştir. Bu testlerin toplam maliyeti 56.153 TL olarak hesaplanmıştır. Sonuç: Bu çalışma viral hepatit serolojisinde kullanılan testlerin önemli bir kısmının uygunsuz istem olduğunu göstermektedir. Tanısal algoritmalar, ciddi bir iş yükü ve maliyet getiren uygunsuz test istemlerini azaltmak için daha yaygın olarak kullanılmalıdır.

Viral hepatit serolojik testlerinin uygunsuz istemi

Objectives: Inappropriate end excessive requests of laboratory tests are labor intensive and a vast burden of cost. Diagnostic algorithms are advised to prevent inap- propriate and excessive usage of tests. In this study it was aimed to determine inappropriate test ordering rates and cost. Materials and methods: To assess the number of inap- propriate test orders, laboratory records of samples sent for hepatitis A and B viral serologic tests were evaluat- ed retrospectively with respect to diagnostic algorithms. Orders including serological marker groups without ad- equate clinical information whether or not the order was inappropriate was excluded from the study. Results: According to the diagnostic algorithms 1.452 anti-HAV IgM tests, 1.452 anti-HAV total tests, 208 anti- HBs tests, 208 anti-HBc total tests, 1.210 anti-HBc IgM tests, 1.358 HBeAg tests and 1.216 anti-HBe tests are inappropriate requests. Total cost of these tests is calcu- lated as 56.153 TL. Conclusion: This study shows that a significant amount of hepatitis serologic tests are inappropriate requests. Diagnostic algorithms for hepatitis should be used more commonly to decrease the amount of inappropriate re- quests result in significant workload and cost. J Clin Exp Invest 2012; 3(2): 181-184

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