title: The impact of local guidelines on the tumour marker requesting patterns of a General Surgery Department.
abstract: BACKGROUND
  The inappropriate use of tumour markers (TMs) is a common problem. The aim of this audit was to evaluate the impact of local guidelines on the TM requesting patterns of a General Surgery Department.
  
  
  METHODS
  CA 125, CA 19-9, CA15-3, CEA, AFP and HCG requests from all hospital surgical locations were audited over two periods of eight months before and after the implementation of local requesting guidelines.
  
  
  RESULTS
  Postintervention, total TM requests decreased by 32% while patient requests decreased by 9.8%. Single TM requesting increased and requests for panels containing four or more TMs decreased from 279 to 60 requests (78% reduction).
  
  
  CONCLUSIONS
  Interdepartmental collaboration and the implementation of local guidelines have resulted in a change in requesting behaviour, most notably a reduction in multiple TM panel requests.
authors.affiliation: Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK. Danja.Schulenburg-brand@wales.nhs.uk
authors.forename: Danja
authors.initials: D
authors.lastname: Schulenburg-Brand
authors.forename: Nagappan
authors.initials: N
authors.lastname: Kumar
authors.forename: Soha
authors.initials: S
authors.lastname: Zouwail
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis* / Q000191:economics; D018394:CA-125 Antigen / Q000032:analysis / Q000191:economics; D018395:CA-19-9 Antigen / Q000032:analysis / Q000191:economics; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000191:economics; D006063:Chorionic Gonadotropin / Q000032:analysis / Q000191:economics; D013502:General Surgery; D019983:Guideline Adherence / Q000458:organization & administration*; D006785:Hospitals, University; D006801:Humans; D008485:Medical Audit / Q000941:ethics / Q000706:statistics & numerical data; D018396:Mucin-1 / Q000032:analysis / Q000191:economics; D017410:Practice Guidelines as Topic; D017749:Total Quality Management / Q000458:organization & administration*; D000509:alpha-Fetoproteins / Q000032:analysis / Q000191:economics
chemical_list: C097353:AFP protein, human; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D006063:Chorionic Gonadotropin; D018396:Mucin-1; D000509:alpha-Fetoproteins
keywords: Tumour markers; analytes; laboratory management; laboratory methods