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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
PubMed

Insights

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.
Abstract

Keywords:
algorithmceliacceliac disease laboratory test utilizationceliac reflexive testlaboratory test usagemanagement

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