IQ Health science department, Radboud University Medical Centre, Nijmegen, The Netherlands
IQ Health science department, Radboud University Medical Centre, Nijmegen, The Netherlands.
BMJ Open. 2024 Feb 28;14(2):e075241. doi: 10.1136/bmjopen-2023-075241.
To assess the extent of non-indicated vitamin B- and D-testing among Dutch clinicians and its variation among hospitals.
Cross-sectional study using registration data from 2015 to 2019.
Patients aged between 18 and 70 years who received a vitamin B- or D-test.
The proportion of non-indicated vitamin B- and D-testing among Dutch clinicians and its variation between hospitals (n=68) over 2015-2019.
Between 2015 and 2019, at least 79.0% of all vitamin B-tests and 82.0% of vitamin D-tests lacked a clear indication. The number of vitamin B-tests increased by 2.0% over the examined period, while the number of D-tests increased by 12.2%. The proportion of the unexplained variation in non-indicated vitamin B- and D-tests that can be ascribed to differences between hospitals remained low. Intraclass correlation coefficients ranged between 0.072 and 0.085 and 0.081 and 0.096 for non-indicated vitamin B- and D-tests, respectively. The included casemix variables patient age, gender, socioeconomic status and hospital size only accounted for a small part of the unexplained variation in non-indicated testing. Additionally, a significant correlation was observed in non-indicated vitamin B- and D-testing among the included hospitals.
Hospital clinicians order vitamin B- and D-tests without a clear indication on a large scale. Only a small proportion of the unexplained variation could be attributed to differences between hospitals.
评估荷兰临床医生中非指征性维生素 B 和 D 检测的程度及其在医院间的差异。
使用 2015 年至 2019 年的登记数据进行横断面研究。
年龄在 18 至 70 岁之间接受维生素 B 或 D 检测的患者。
2015 年至 2019 年期间荷兰临床医生中非指征性维生素 B 和 D 检测的比例及其在医院间的差异（n=68）。
在 2015 年至 2019 年间，至少 79.0%的所有维生素 B 检测和 82.0%的维生素 D 检测缺乏明确的指征。在研究期间，维生素 B 检测数量增加了 2.0%，而 D 检测数量增加了 12.2%。无法解释的非指征性维生素 B 和 D 检测变异中归因于医院间差异的比例仍然较低。未解释的变异部分在非指征性维生素 B 和 D 检测中的组内相关系数分别为 0.072 至 0.085 和 0.081 至 0.096。纳入的病例组合变量患者年龄、性别、社会经济地位和医院规模仅占非指征性检测中未解释变异的一小部分。此外，在所纳入的医院中还观察到非指征性维生素 B 和 D 检测之间存在显著相关性。
医院临床医生大规模开具无明确指征的维生素 B 和 D 检测。无法解释的变异中只有一小部分可以归因于医院间的差异。
