title: [Impact of the implementation of a protocol for the adequate and safe use of tumor markers].
abstract: OBJECTIVE
  Improper clinical use of tumor markers (TM) may cause unnecessary additional studies to confirm or refute a positive result. After observing 2 adverse events due to a wrong use of TM, a protocol for improving their use was implemented. The objective of this study was to determine the impact of the implementation of the protocol.
  
  
  METHODS
  This was a pre-postintervention study, where analytical requests of carcinoembryonic antigen, CA15.3, CA19.9 and CA125 were analyzed during one year in patients not undergoing checking of neoplasia. A protocol was implemented and physicians were trained as recommended by the European Group on Tumor Markers, limiting its use to monitor the disease and its treatment. The study period was 2010-2014.
  
  
  RESULTS
  The total number of requests dropped 50.81% and the percentage of adequacy of TM increased, each year, from 31.03 to 77.91%.
  
  
  CONCLUSIONS
  The implementation of a protocol for the proper use of TM contributes to a safer use, avoiding incorrect studies and unnecessary and harmful tests for the patient.
authors.affiliation: Laboratorio Clínico, Área de Gestión Sanitaria Serranía de Málaga, Málaga, España. Electronic address: franciscoj.merida.sspa@juntadeandalucia.es.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Mérida de la Torre
authors.affiliation: Farmacia, Área de Gestión Sanitaria Serranía de Málaga, Málaga, España; Universidad de Málaga, Málaga, España.
authors.forename: Elvira Eva
authors.initials: EE
authors.lastname: Moreno Campoy
authors.affiliation: Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martos Crespo
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D002985:Clinical Protocols; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000175:diagnosis*; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
chemical_list: D014408:Biomarkers, Tumor
keywords: Guideline; Marcador tumoral; Monitoring; Monitorización; Patient safety; Protocolo; Seguridad del paciente; Tumor markers