Use of Rheumatology Laboratory Studies Among Primary Pediatricians

C. K. Correll; L. G. Spector; L. Zhang; B. A. Binstadt; R. K. Vehe

Use of Rheumatology Laboratory Studies Among Primary Pediatricians

C. K. Correll, L. G. Spector, L. Zhang, B. A. Binstadt, R. K. Vehe

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Abstract

Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.

Original language	Undefined/Unknown
Journal	Clinical Pediatrics
State	Published - Jan 10 2016

Bibliographical note

LR: 20160113; CI: (c) The Author(s) 2016; JID: 0372606; OTO: NOTNLM; aheadofprint

Keywords

HLA-B27
antinuclear antibody
cyclic citrullinated peptide
double-stranded DNA
laboratory test
pediatric rheumatology
pediatrician
primary care
referral
rheumatoid factor

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title = "Use of Rheumatology Laboratory Studies Among Primary Pediatricians",

abstract = "Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.",

keywords = "HLA-B27, antinuclear antibody, cyclic citrullinated peptide, double-stranded DNA, laboratory test, pediatric rheumatology, pediatrician, primary care, referral, rheumatoid factor",

author = "Correll, {C. K.} and Spector, {L. G.} and L. Zhang and Binstadt, {B. A.} and Vehe, {R. K.}",

note = "LR: 20160113; CI: (c) The Author(s) 2016; JID: 0372606; OTO: NOTNLM; aheadofprint",

year = "2016",

month = jan,

day = "10",

language = "Undefined/Unknown",

journal = "Clinical Pediatrics",

issn = "0009-9228",

publisher = "SAGE Publications Inc.",

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TY - JOUR

T1 - Use of Rheumatology Laboratory Studies Among Primary Pediatricians

AU - Correll, C. K.

AU - Spector, L. G.

AU - Zhang, L.

AU - Binstadt, B. A.

AU - Vehe, R. K.

N1 - LR: 20160113; CI: (c) The Author(s) 2016; JID: 0372606; OTO: NOTNLM; aheadofprint

PY - 2016/1/10

Y1 - 2016/1/10

N2 - Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.

AB - Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.

KW - HLA-B27

KW - antinuclear antibody

KW - cyclic citrullinated peptide

KW - double-stranded DNA

KW - laboratory test

KW - pediatric rheumatology

KW - pediatrician

KW - primary care

KW - referral

KW - rheumatoid factor

M3 - Article

C2 - 26755273

SN - 0009-9228

JO - Clinical Pediatrics

JF - Clinical Pediatrics

ER -