Application of hepatitis serology testing algorithms to assess inappropriate laboratory utilization.
OBJECTIVE
Many studies pointed out inappropriate utilization of laboratory caused by excessive amounts of tests ordered by doctors. To prevent and to eliminate the ordering of unhelpful tests, introducing diagnostic algorithms, which are also a suitable practice for application to hepatitis serology, have been suggested. This study aimed to determine inappropriate test ordering rates with respect to the commonly approved algorithms for serological diagnosis of viral hepatitis.


METHODS
To assess the number of inappropriate test orders, laboratory records of samples sent for hepatitis A, B, and D serology were reviewed and evaluated retrospectively with respect to algorithms for serological diagnosis of viral hepatitis. Orders including serological marker groups with inadequate clinical information to determine whether or not the order was inappropriate were excluded from the analysis.


RESULTS
Application of diagnostic algorithms showed that 50% of anti-HAV IgM and anti-HAV total; 12.7% of anti-HBs, 12.7% of anti-HBc total, 78.5% of anti-HBc IgM, 87.3% of HBe Ag, 78.8% of anti-HBe, 58.7% of anti-HD total orders were made inappropriately.


CONCLUSIONS
Our study provides information for inappropriate laboratory utilization for hepatitis serology testing and we suggest to use diagnostic algorithms applied by the serology laboratory to decrease the rate of unhelpful test orders.
Dokuz Eylul University Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Inciralti, Izmir, Turkey.
Ozgen A
OA
Ozbek
Mehmet A
MA
Oktem
Guliz
G
Dogan
Yusuf H
YH
Abacioglu
D000465:Algorithms; D006403:Hematologic Tests / Q000706:statistics & numerical data*; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D007755:Laboratories, Hospital / Q000706:statistics & numerical data*; D014421:Turkey; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D014600:Utilization Review