Related Experiment Video
Updated: Jan 17, 2026
Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
Rational test request in autoimmune rheumatological disease diagnosis evaluation of immunoblot requests with
Mehmet Akif Durmuş1, Beyza Öncel1
1Başakşehir Çam and Sakura City Hospital, Istanbul, Türkiye.
Background:
This study evaluated clinician adherence to unrestricted antinuclear antibody (ANA) and subserology test requests, comparing rheumatologists and other specialists, and assessed the financial impact of inappropriate orders.
Research Design And Methods:
We analyzed 43,691 patients tested for ANA IIF from January 2022 to June 2024. ENA profile immunoblot requests without appropriate ANA IIF positivity were categorized by specialty.
Results:
Rheumatologists ordered 11,581 ANA IIF tests (26.51%), while non-rheumatology physicians ordered 32,110 (73.49%). Of ANA IIF-negative results, 55.82% had ENA immunoblots, with rheumatologists (73.97%) and non-rheumatologists (50.42%) contributing to unnecessary requests. After implementing reflex testing, specialist training, and ELISA, the ENA immunoblot claim rate decreased from 58.44% to 20% within one year, resulting in an annual savings of €121,000.
Conclusions:
Reflex testing and laboratory-guided algorithms reduce unnecessary orders, maintain diagnostic accuracy, and achieve significant cost savings through enhanced collaboration between clinicians and laboratories.
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