Prospective evaluation of a clinical guideline for the diagnosis and management of iron deficiency anemia
| Autor: | Kevin L. Scott, George N. Ioannou, Jeremy Spector, Don C. Rockey |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Anemia Prospective evaluation Endoscopy Gastrointestinal Age Distribution Risk Factors Internal medicine Outcome Assessment Health Care North Carolina Odds Ratio medicine Humans Prospective Studies Hospitals Teaching Prospective cohort study Mean corpuscular volume Aged Gastrointestinal Neoplasms Evidence-Based Medicine Hepatology Anemia Iron-Deficiency medicine.diagnostic_test biology business.industry Gastroenterology General Medicine Odds ratio Guideline Middle Aged medicine.disease Confidence interval Surgery Ferritin Iron-deficiency anemia Ferritins Practice Guidelines as Topic biology.protein Female Guideline Adherence business |
| Zdroj: | The American Journal of Medicine. 113:281-287 |
| ISSN: | 0002-9343 |
| DOI: | 10.1016/s0002-9343(02)01226-3 |
| Popis: | We examined the effect of introducing an evidence-based clinical guideline on the diagnosis and evaluation of iron deficiency anemia.The guideline recommended measurement of serum ferritin levels for all anemic patients with a mean corpuscular volume (MCV)/=95 fL and endoscopic evaluation for those with a serum ferritin level less than 45 ng/mL. Physicians practicing in the general medicine inpatient and outpatient services of two university-affiliated hospitals were informed about the guideline and the data supporting it. Clinical evaluations during the 9 months before ("control period," n = 3341 patients) and the 9 months after ("intervention period," n = 3173 patients) the introduction of the guideline were compared.There was a 30% increase (95% confidence interval [CI]: 22% to 39%) in the proportion of anemic patients who underwent serum ferritin evaluation in the intervention period (41% [n = 1284]) compared with in the control period (31% [n = 1040]), and a 24% increase (95% CI: 4% to 48%) in the proportion with a serum ferritin level45 ng/mL (8.1% [n = 256] vs. 6.5% [n = 217]). The proportion of anemic patients who underwent endoscopic evaluation within 4 months of measurement of low serum ferritin level in the intervention period (3.3% [n = 106]) was 67% higher (95% CI: 23% to 125%) than in the control period (2.0% [n = 67]), and the proportion with serious gastrointestinal lesions found as a result of endoscopy was 62% (95% CI: 8% to 145%) higher (1.8% [n = 57] vs. 1.1% [n = 37]).Introduction of a guideline describing appropriate evaluation of iron deficiency anemia led to an increase in the proportions of patients evaluated for iron deficiency anemia and found to have serious gastrointestinal lesions. |
| Databáze: | OpenAIRE |
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