荷兰医院临床医生的非指示维生素B和D测试:数据注册表中的横截面分析
Joris Ljm Müskens1, Rudolf Bertijn Kool2, Gert P Westert2
1IQ Health science department, Radboud University Medical Centre, Nijmegen, The Netherlands Joris.muskens@radboudumc.nl.
BMJ open
|February 28, 2024
概括
荷兰的临床医生经常在没有明确的指示的情况下订购维生素B12和D测试,超过79%的B12测试和82%的D测试是不适用的. 在这些非指示测试中,医院的变化很小.
科学领域:
- 临床诊断 临床诊断 临床诊断
- 实验室医学 实验室医学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 维生素B12和维生素D测试是常见的诊断程序.
- 不适用的测试可能会导致医疗保健成本增加和潜在的患者伤害.
- 了解非指示测试的范围和变化对于优化临床实践至关重要.
研究的目的:
- 为了评估荷兰非指示维生素B12和D测试的流行情况.
- 调查荷兰医院之间非指示性检测实践的差异.
- 识别导致非指示维生素检测的因素.
主要方法:
- 一项利用2015年至2019年的注册数据进行的横截面研究.
- 分析包括18至70岁的患者,他们接受了维生素B12或D测试.
- 检查了非指示测试的比例和医院间的变化.
主要成果:
- 在2015-2019年期间,至少79%的维生素B12测试和82%的维生素D测试缺乏明确的指示.
- 在研究期间,维生素B12测试数量增加了2.0%,维生素D测试数量增加了12.2%.
- 较低的类内相关系数 (0.072-0.096) 显示了可归因于医院差异的微小不明原因变化.
结论:
- 医院临床医生在没有明确指示的情况下广泛订购维生素B12和D测试.
- 医院之间的差异只占非指示测试中无法解释的变化的一小部分.
- 需要进一步的研究来理解和解决广泛的非指示维生素测试问题.
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