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Utilization of Laboratory Testing Algorithms for Celiac Disease in a Pediatric Hospital
Mahesheema Ali1, Derek J Danner2, Douglas S Fishman3
1Department of Pathology, SUNY Upstate Medical University, Syracuse, New York.
Laboratory Medicine
|June 19, 2019
Summary
Implementing a celiac-reflexive cascade significantly improved appropriate celiac test ordering and reduced costs. This initiative ensured tests were used correctly, benefiting patient care and hospital budgets.
Area of Science:
- Clinical Diagnostics
- Healthcare Management
- Gastroenterology
Background:
- Numerous celiac tests were ordered by non-specialist providers at Texas Children's Hospital.
- Varied ordering practices led to potential overuse and increased costs.
Purpose of the Study:
- To evaluate the impact of a test ordering initiative on celiac test usage.
- To determine if the initiative improved appropriate test utilization and reduced healthcare costs.
Main Methods:
- Retrospective analysis of celiac test orders from July 2016 to September 2017.
- Implementation of an in-house celiac-disease screening cascade.
- Reflex testing to a comprehensive panel based on abnormal screening results.
Main Results:
- Out of 60 total orders, only 4 proceeded to comprehensive celiac testing.
- 52 orders were altered to celiac screening, with 1 positive result reflexed.
- 4 orders were canceled due to incorrect submissions.
Conclusions:
- A celiac-reflexive cascade effectively improved appropriate celiac test ordering.
- The implemented strategy demonstrated significant cost-effectiveness.
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