A Q-Probes Study Involving Utilization of Free Prostate-Specific Antigen, Factor V Leiden, and Hepatitis A Serology Tests.

Context.--Managing the utilization of laboratory tests is an important quality improvement activity that adds value to health care. Objective.--To examine utilization of 3 laboratory tests and identify factors that impact performance. Design.--Test utilization performance was evaluated by determinin...

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Published in:Archives of Pathology & Laboratory Medicine Vol. 143; no. 2; pp. 151 - 157
Main Authors: Schifman, Ron B., Perrotta, Peter L., Souers, Rhona, Blond, Barbara J.
Format: research tables/charts Journal Article
Published: College of American Pathologists Feb2019
Online Access:View this record in EBSCOhost
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      dt: Feb2019
      vid: 143
      iid: 2
      pid: 2550
      pub: College of American Pathologists
      place: Northfield, Illinois
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        134272555
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        10.5858/arpa.2018-0010-CP
        134272555
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        atl: A Q-Probes Study Involving Utilization of Free Prostate-Specific Antigen, Factor V Leiden, and Hepatitis A Serology Tests.
      aug:
        au:
          Schifman, Ron B.
          Perrotta, Peter L.
          Souers, Rhona
          Blond, Barbara J.
        affil: Pathology and Laboratory Medicine, Southern Arizona VA Healthcare System, and the Department of Pathology, University of Arizona, Tucson
      sug:
        subj:
          Prostate-Specific Antigen Blood
          Factor V Leiden Blood
          Hepatitis A Diagnosis
          Serology
          Proficiency Testing, Laboratory Utilization
          Human
          Antibodies, Viral
          Mutation
          Diagnostic Errors Risk Factors
      ab: Context.--Managing the utilization of laboratory tests is an important quality improvement activity that adds value to health care. Objective.--To examine utilization of 3 laboratory tests and identify factors that impact performance. Design.--Test utilization performance was evaluated by determining the frequency with which appropriate preconditions for testing were met. This included 30 testing episodes each involving (1) free prostate-specific antigen (PSA) when total PSA was within an appropriate interpretable range, (2) total anti--hepatitis A virus antibody when previous anti--hepatitis A virus antibody results were either negative or not done, and (3) factor V Leiden mutation when a previous result was not already available. Participants also provided information regarding some of their utilization policies and procedures for these 3 tests. Results.--The overall frequency with which testing criteria were met was 20.6% (163 of 790), 91.5% (649 of 709), and 95.2% (799 of 839) for free PSA, anti-- hepatitis A virus antibody, and factor V Leiden, respectively. Utilization review was infrequent and done by 20.7% (6 of 29) of participants for factor V Leiden, 3.6% (1 of 28) for anti--hepatitis A virus antibody, and 3.6% (1 of 28) for free PSA. No practice or demographic characteristics were significantly associated with utilization performance for any test. Conclusions.--Utilization review was infrequent for the 3 tests examined. Variable amounts of unnecessary testing were observed for all tests, most frequently for free PSA, for which reporting results carried the added risk of diagnostic error from misinterpretation of results.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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