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[Is cobalamin measurement overprescribed by physicians? Results of an eight-year single academic centre survey]

J-B Arlet1, A Rachas2, I Colombet2

  • 1Service de médecine interne, hôpital Européen Georges-Pompidou, faculté de médecine Paris Descartes, Sorbonne Paris-Cité et AP-HP, 20, rue Leblanc, 75015 Paris, France.

La Revue De Medecine Interne
|July 5, 2014
PubMed

Insights

Cobalamin (vitamin B12) blood tests doubled in hospitals despite limited clinical indications. New guidelines are needed to justify the increased use of this common inpatient assay.

Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Internal Medicine

Context:

  • Cobalamin (vitamin B12) measurement is a frequent inpatient laboratory test.
  • Existing clinical indications for cobalamin testing have been limited and declining.
  • The study examines trends in cobalamin assay volume over an eight-year period.

Purpose:

  • To retrospectively evaluate changes in the volume of cobalamin (vitamin B12) measurements in an academic medical center.
  • To assess the appropriateness of increased cobalamin assay ordering in clinical practice.

Summary:

  • The annual number of cobalamin assays doubled between 2005 and 2012.
  • The proportion of inpatients with cobalamin levels measured increased significantly, reaching 84% in some departments.
  • This increase in testing volume was not supported by new scientific evidence or expanded indications.

Impact:

  • Highlights a significant rise in cobalamin (vitamin B12) testing without clear justification.
  • Underscores the need for updated national and international guidelines for inpatient cobalamin assay ordering.
  • Suggests potential for improved resource allocation and reduced unnecessary laboratory utilization.
Abstract

Keywords:
CobalaminInternal medicineMédecine internePrescriptionVitamine B12

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