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Related Concept Videos

Hyperglycemia01:29

Hyperglycemia

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Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
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Here is a stepwise guide to assessing the body temperature at the temporal artery using a temporal artery thermometer
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Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
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Therapeutic Drug Monitoring: Affecting Factors01:29

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Related Experiment Video

Updated: Apr 28, 2026

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
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Temporal trends of hemoglobin A1c testing.

Rimma Pivovarov1, David J Albers1, George Hripcsak1

  • 1Department of Biomedical Informatics, Columbia University, New York, USA.

Journal of the American Medical Informatics Association : JAMIA
|June 15, 2014
PubMed
Summary
This summary is machine-generated.

Healthcare costs can be reduced by analyzing laboratory test utilization. This study found that hemoglobin A1c (HbA1c) testing shows overutilization, with frequent repeat testing not aligning with clinical guidelines.

Keywords:
Electronic Health RecordsGuideline AdherenceLaboratory Test OverutilizationTemporal Trends

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Area of Science:

  • Health Services Research
  • Clinical Laboratory Science
  • Health Informatics

Background:

  • Laboratory test utilization patterns are crucial for identifying potential overuse and reducing healthcare costs.
  • Electronic Health Records (EHRs) offer a valuable data source for analyzing test ordering trends over time.

Purpose of the Study:

  • To demonstrate the use of distributional analytics for comparing EHR laboratory test orders across time.
  • To diagnose and quantify overutilization of laboratory tests, specifically hemoglobin A1c (HbA1c).

Main Methods:

  • Analyzed 15 years of HbA1c testing data for 119,000 patients.
  • Examined HbA1c ordering patterns before and after the 2002 American Diabetes Association guidelines.
  • Compared ordering distributions to assess adherence to guidelines and identify deviations.

Main Results:

  • HbA1c orderings steadily increased over time, with a rise in low-value (<6.5%) measurements.
  • A significant change in ordering patterns occurred post-2002 guidelines (p<0.001).
  • Ordering changes indicated rapid-repeat testing, deviating from both 2002 and 2009 guidelines.

Conclusions:

  • HbA1c test overutilization is suggested, driven by factors like poor care coordination and confirmatory testing after point-of-care results.
  • Distributional analytics of EHR data provide a useful method for identifying and assessing inappropriate test use trends.