医生的专业领域是否重要？
Does Provider Specialty Matter?
机构信息
Department of Laboratory Medicine, University of Washington, Seattle.
Department of Pediatrics, University of Washington, Seattle.
出版信息
Am J Clin Pathol. 2019 Nov 4;152(6):701-705. doi: 10.1093/ajcp/aqz097.
OBJECTIVES
Multiple practice guidelines discourage indiscriminate use of broad panels of allergen-specific IgE (sIgE) tests due to increased risk of false positives and misinterpretation of results. We provide an analytical framework to identify specialty-specific differences in ordering patterns and effectiveness, which can be used to improve test utilization.
METHODS
Test results from a tertiary pediatric hospital were analyzed by ordering specialty to evaluate size of allergen workups. Positivity rates were analyzed to determine effectiveness in selecting tests with high positive pretest probabilities. Laboratory test menu components were also evaluated.
RESULTS
Our findings demonstrate 29% of sIgE tests are ordered as part of broad workups (>20 sIgE tests/date of service) contrary to the recommended testing approach. Detailed descriptions of ordering patterns and positivity rates are provided.
CONCLUSIONS
This study provides a framework for using a cross-sectional analytical approach to assess test utilization patterns and evaluate components of laboratory testing menus.
目的
由于假阳性风险增加和结果解读错误，多项临床实践指南不鼓励不加选择地使用广泛的过敏原特异性 IgE（sIgE）检测面板。我们提供了一个分析框架，用于确定专科间在检测模式和效果上的差异，这可用于改进检测的使用。
方法
通过专科订单分析了一家三级儿科医院的检测结果，以评估过敏原检测的规模。分析阳性率以确定在选择具有高阳性预测值的检测时的效果。还评估了实验室检测菜单的组成部分。
结果
我们的研究结果表明，29%的 sIgE 检测是作为广泛检测的一部分（>20 项 sIgE 检测/就诊日期），这与推荐的检测方法相悖。我们提供了详细的订单模式和阳性率描述。
结论
本研究提供了一个使用横断面分析方法来评估检测使用模式和评估实验室检测菜单组成部分的框架。
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