优化抗脂抗体检测:对适当性和资源利用的现实世界分析
Silvia Grazietta Foddai1,2, Maria Infantino3, Mariangela Manfredi3
1University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERKNet, ERN-Reconnet and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, San Giovanni Bosco Hub Hospital, Turin, 10154, Italy.
Immunologic research
|September 16, 2025
概括
许多抗脂抗体 (aPL) 测试被不适当地要求,增加了医疗保健成本和环境影响. 优化诊断建议和医生教育对于适当的aPL测试至关重要.
科学领域:
- 临床免疫学临床免疫学
- 医疗保健管理的管理
- 诊断 实验室医学 诊断 实验室医学
背景情况:
- 有效地利用医疗保健资源对于可持续性和成本效益至关重要.
- 抗脂综合征 (APS) 诊断需要临床事件和抗脂抗体 (aPL) 检测.
- 不适当的aPL测试请求导致医疗保健费用增加和环境负担增加.
研究的目的:
- 评估抗脂抗体 (aPL) 测试在临床环境中的适当性.
- 为了识别不同医学专业不适当的aPL测试请求的模式.
- 评估不适当的测试对医疗保健成本和资源利用的影响.
主要方法:
- 在圣乔瓦尼迪迪奥医院对642名患者的检测请求进行了回顾性分析 (11/2023-02/2024).
- 用基于临床建议的评分系统将诊断怀疑分类为适当,不适当或无价值.
- 分析患者的人口统计,检测结果,并订购医生专业.
主要成果:
- 36%的aPL测试请求是合适的,42%是不合适的,22%没有价值.
- 家庭医生提出了53%的请求,不适当率最高 (44%).
- 只有4.9%的患者符合全面aPL测试的国际标准;不适当的请求往往缺乏临床理由.
结论:
- 很大一部分aPL测试缺乏临床理由,这表明准则遵守的变化.
- 不适当的测试导致医疗保健成本增加,专家转诊和环境影响.
- 改善医生教育和遵守诊断建议对于优化aPL测试和资源使用至关重要.
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