Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Ann Clin Lab Sci. 2024 Mar;54(2):211-216.
Vitamin B12 is an essential nutrient for numerous functions in the human body. As such, many clinical scenarios justify assaying serum B12; however, there are no evidence-based guidelines available for determining when to order B12 tests. Here we investigate B12 assay ordering patterns to identify methods of enhancing efficiency and minimizing inappropriate requests.
All serum B12 requests within the year spanning July 2018 to June 2019 were reviewed using the hospital's health information system. These amounted to 3,400 requests, of which data from the first 1,000 were evaluated. Patient demographics, hematological data, serum folate, and ferritin were extracted from the electronic requests. Physician identity and request reason were retrieved where available.
Of the 877 B12 requests for which patient age was available, the majority (80.3%) were for young and middle-aged patients. Interestingly, serum B12 was low in only a quarter of the 1,000 reviewed requests; the remaining three quarters had normal levels. Folate, which can be ordered with vitamin B12, was tested in 82 cases, of which only two (2.4%) had folate deficiency.
This study highlights a high occurrence of improper ordering of vitamin B12 assays, indicating a need for revised guidelines to promote optimal test ordering.
维生素 B12 是人体众多功能所必需的营养物质。因此，许多临床情况都需要检测血清 B12；然而，目前尚无确定何时进行 B12 检测的循证指南。在这里，我们调查了 B12 检测的订购模式，以确定提高效率和减少不适当请求的方法。
使用医院的健康信息系统回顾了 2018 年 7 月至 2019 年 6 月期间的所有血清 B12 请求。这些请求共计 3400 个，其中评估了前 1000 个请求的数据。从电子请求中提取了患者的人口统计学数据、血液学数据、血清叶酸和铁蛋白。在有可用信息的情况下，检索了医生身份和请求原因。
在 877 份提供了患者年龄的 B12 请求中，大多数（80.3%）是为年轻和中年患者请求的。有趣的是，在审查的 1000 个请求中，只有四分之一的血清 B12 水平较低；其余四分之三的水平正常。叶酸可以与维生素 B12 一起订购，在 82 例中进行了检测，其中只有 2 例（2.4%）叶酸缺乏。
本研究强调了维生素 B12 检测的不当订购情况较为常见，表明需要修订指南以促进最佳检测订购。
