title: Use of Rheumatology Laboratory Studies Among Primary Pediatricians.
abstract: Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.
authors.affiliation: 1 University of Minnesota, Minneapolis, MN, USA.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Correll
authors.affiliation: 1 University of Minnesota, Minneapolis, MN, USA.
authors.forename: Logan G
authors.initials: LG
authors.lastname: Spector
authors.affiliation: 1 University of Minnesota, Minneapolis, MN, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 1 University of Minnesota, Minneapolis, MN, USA.
authors.forename: Bryce A
authors.initials: BA
authors.lastname: Binstadt
authors.affiliation: 1 University of Minnesota, Minneapolis, MN, USA.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Vehe
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D006801:Humans; D000072143:Pediatricians / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012216:Rheumatic Diseases / Q000175:diagnosis*
keywords: HLA-B27; antinuclear antibody; cyclic citrullinated peptide; double-stranded DNA; laboratory test; pediatric rheumatology; pediatrician; primary care; referral; rheumatoid factor