University of Twente Student Theses
Preventing overuse of diagnostic test s: a case study into analyzing the impact of a limited set of laboratory test results on correctly diagnosing the underlying cause of anemia by clinical chemists.
Wielen, Dèlon van der (2020) Preventing overuse of diagnostic test s: a case study into analyzing the impact of a limited set of laboratory test results on correctly diagnosing the underlying cause of anemia by clinical chemists.
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| Abstract: | Background: In this study the percentage of correctly diagnosed underlying cause of anemia by clinical chemists is investigated. Clin-ical chemists were asked to use a full set of laboratory test results and a limited set of six laboratory test results. Methods: An online survey was build and distributed among 372 clinical chemists and clinical chemists in training affiliated with Netherlands Society for Clinical Chemistry and Laboratory Medicine (NVKC). This survey contained three sections: demographic questions, three cases with all available laboratory test results (n=15) free of choice and three cases with a smaller set of laboratory test results (n=6) containing: Hemoglobin, ferritin, C-reactive protein (CRP), mean corpuscular volume (MCV), Transferrin and folic acid . All cases were derived from a large database of real records suffering from a newly diag-nosed anemia. After requesting laboratory test results, respondents were asked to determine an underlying cause of anemia. The re-spondents were presented three cases in the third section of the survey, in this section the respondents were asked for an underly-ing cause of anemia based on the limited set of laboratory results. Results: 68 clinical chemist responded to the online survey and diagnosed 58,8% of the presented cases with personally requested laboratory test results correctly compared with the diagnoses given by an expert panel. 56,6% of the cases presented with the limited subset of six laboratory test results were diagnosed correctly. MCV, hemoglobin and ferritin were requested the most. The value of Fleiss’ kappa showed that diagnosing iron deficiency (IDA) was carried out best. After analyzing the combinations of requested laboratory test results, no exact agreement was found between the combinations of requested laboratory test results and the limited set of laboratory test results. Conclusion: based on the almost equal percentages of correctly diagnosing the underlying cause of anemia, evidence was found that a limited set of laboratory test results will contribute to prevent the overuse of diagnostic tests in correctly diagnosing the underlying cause of anemia by clinical chemists in the Netherlands |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 70 social sciences in general |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/82784 |
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