Screening with the activated protein C resistance assay yields significant savings in a patient population with low prevalence of factor V leiden.
Testing for factor V Leiden can be performed with a molecular assay or a test for activated protein C resistance. We noted that physicians in our institution tended to order the molecular test 80% of the time, but the prevalence of the mutation in our patient population was less than 10%. Consequently, we decided to introduce the activated protein C resistance assay in house and consistently use it for screening before the more expensive genetic test and to negotiate a discounted charge for the latter at a reference laboratory. After 6 years since these interventions began, the prevalence of an abnormal screening test result remained low (202/2,475 [8.2%]), even among white patients (10.9%). With this simple approach, the cost to test patients for factor V Leiden decreased by more than 90%, while the productivity of our laboratory increased by the introduction of a high-volume, fully automated assay.
Taylor
Laura J
LJ
UAB Coagulation Service, Department of Pathology and Hospital Laboratories, University of Alabama, Birmingham, AL 35249-7331, USA.
Oster
Robert A
RA
Fritsma
George A
GA
Tichenor
Patricia H
PH
Reed
Cari E
CE
Eiland
Barbara M
BM
Hudson
Christine L
CL
Marques
Marisa B
MB
D020016:Activated Protein C Resistance / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology*; D005165:Factor V / Q000235:genetics*; D005260:Female; D005821:Genetic Techniques / Q000191:economics; D006403:Hematologic Tests / Q000191:economics; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods*; D008875:Middle Aged; D009154:Mutation; D015995:Prevalence; D011486:Protein C / Q000032:analysis*; D012680:Sensitivity and Specificity
D011486:Protein C; C095381:factor V Leiden; D005165:Factor V