title: [Measurements of PSA and of vitamin D: a period of 3-months of use of special forms based on the guidelines of the Haute autorité de santé shows a clear improvement of prescription behaviors].
abstract: In France practice guidelines of the Haute Autorité de santé (HAS) are not implemented as often as they should. As a consequence resources are wasted that could be useful elsewhere. In Avril 2014 prescription-forms were introduced in our hospital for PSA and for vitamin-D. If those forms were not filled-in by the physicians, then PSA and vitamin-D were not measured any more by our laboratory. PSA was measured in only two circumstances: therapeutic follow-up of, or screening for, prostate cancer. Patients had to give their formal consent for being screened with PSA. Vitamin-D was measured in the only six circumstances recommended by the HAS. After a few months of use of these two forms we observe a sharp decrease in PSA, and even more so in vitamin D, measurements. Our prescription-forms' legitimacy is high because they are based on governmental guidelines. All the more since the values that are promoted in these guidelines clearly cover the four core principles of bioethics, that is beneficence, non-malevolence, respect for the patient's autonomy (particularly for PSA) and equity. Our results need to be confirmed over a longer period of time, and to be analysed in more detail, particularly regarding the way consent forms are filled-in by the patients.
authors.affiliation: Hôpital de la Chartreuse, Villefranche-de-Rouergue, France.
authors.forename: Joseph
authors.initials: J
authors.lastname: Watine
mesh_terms: D001774:Blood Chemical Analysis / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D004992:Ethics, Medical; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000639:trends; D006801:Humans; D007610:Kallikreins / Q000032:analysis* / Q000097:blood; D010818:Practice Patterns, Physicians' / Q000941:ethics / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D055656:Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D017430:Prostate-Specific Antigen / Q000032:analysis* / Q000097:blood; D011787:Quality of Health Care; D011996:Records / Q000592:standards*; D014807:Vitamin D / Q000032:analysis* / Q000097:blood
chemical_list: D014807:Vitamin D; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: PSA; bioethics; quality of care; recommendations; vitamin D