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 | English (US) |
|---|---|
| Pages (from-to) | 1279-1288 |
| Number of pages | 10 |
| Journal | Clinical Pediatrics |
| Volume | 55 |
| Issue number | 14 |
| DOIs | |
| State | Published - Dec 1 2016 |
Bibliographical note
Funding Information:Statistical support was provided by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114 to the University of Minnesota Clinical and Translational Sciences Institute.
Publisher Copyright:
© The Author(s) 2015.
Keywords
- HLA-B27
- antinuclear antibody
- cyclic citrullinated peptide
- double-stranded DNA
- laboratory test
- pediatric rheumatology
- pediatrician
- primary care
- referral
- rheumatoid factor