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Liver function testing in a working population: three strategies to reduce false-positive results
C Wright1, J C Rivera, J H Baetz
1Division of Occupational Medicine, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, MD.
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
|September 1, 1988
Summary
Mildly abnormal liver panel results in healthy workers caused hiring delays. Three strategies effectively reduce false positives without compromising test sensitivity, improving efficiency for both employees and employers.
Area of Science:
- Clinical Chemistry
- Occupational Health
- Diagnostic Testing
Background:
- Liver panel tests are commonly used in occupational health screenings.
- Asymptomatic individuals may exhibit mildly abnormal liver chemistry results.
- These abnormal results can lead to significant hiring process delays.
Purpose of the Study:
- To address the issue of frequent false-positive liver panel results in asymptomatic workers.
- To identify strategies for reducing unnecessary diagnostic procedures and hiring delays.
- To maintain the sensitivity of liver chemistry tests while improving specificity.
Main Methods:
- Analysis of liver panel results from a cohort of asymptomatic workers.
- Evaluation of diagnostic strategies aimed at reducing false-positive rates.
- Assessment of test sensitivity and specificity under different screening protocols.
Main Results:
- A high incidence of mildly abnormal liver chemistry tests was observed in normal, asymptomatic workers.
- These findings frequently resulted in prolonged hiring delays.
- Three distinct strategies were identified that significantly decrease false-positive results.
Conclusions:
- Mildly abnormal liver chemistry tests in asymptomatic workers are common and can impede hiring.
- Implementing specific strategies can effectively reduce false positives.
- These strategies optimize the utility of liver panels in occupational health settings without sacrificing diagnostic accuracy.