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Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Automated diagnostic analyzers have transformed clinical microbiology by providing rapid and reliable methods for pathogen identification and antibiotic susceptibility testing. Among these systems, the Vitek 2 is widely used because it automates the traditionally labor-intensive processes of microbial identification (ID) and antibiotic susceptibility testing (AST), delivering standardized and timely results that are essential for effective patient care.Microbial Identification with ID CardsThe...
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Related Experiment Video

Updated: Mar 22, 2026

Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
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Reducing inappropriate ESR testing with computerized clinical decision support.

Stephanie Gottheil1, Ekta Khemani1, Katherine Copley1

  • 1University of Western Ontario, Canada.

BMJ Quality Improvement Reports
|April 21, 2016
PubMed
Summary
This summary is machine-generated.

Reducing unnecessary laboratory tests like Erythrocyte Sedimentation Rate (ESR) can lower healthcare costs. Implementing Clinical Decision Support (CDS) effectively decreased inappropriate ESR orders by 40% at a major hospital network.

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Area of Science:

  • Clinical Pathology
  • Health Services Research

Background:

  • Laboratory test overutilization contributes to increased healthcare expenses and potential patient harm.
  • The Choosing Wisely Campaign recommends C-reactive protein (CRP) over Erythrocyte Sedimentation Rate (ESR) for inflammation assessment.

Purpose of the Study:

  • To reduce inappropriate Erythrocyte Sedimentation Rate (ESR) orders by 50% at London Health Sciences Centre (LHSC).

Main Methods:

  • Development of appropriateness criteria for ESR testing.
  • Implementation of Plan-Do-Study-Act (PDSA) cycles, starting with an educational bulletin.
  • City-wide rollout of computerized Clinical Decision Support (CDS) tools.

Main Results:

  • A 40% reduction in weekly ESR orders was observed, decreasing from 386 to 241.
  • The intervention demonstrated the effectiveness of CDS in curbing test overutilization.

Conclusions:

  • Clinical Decision Support (CDS) is effective in reducing the ordering of unnecessary laboratory tests.
  • Provider habits significantly influence inappropriate laboratory test ordering practices.