Decision support system through automatic algorithms and electronic request in diagnosis of anaemia for primary care patients
| Autor: | Inmaculada Vinyals-Bellido, Adela Pozo-Giraldez, Ausias Hervas-Romero, Arturo Carratala Calvo, Africa Corchon-Peyrallo, Macarena Diaz-Gimenez, Enrique Rodriguez-Borja |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 030213 general clinical medicine Decision support system referral and consultation diagnosis Cost effectiveness Iron Clinical Biochemistry Primary care 03 medical and health sciences Folic Acid 0302 clinical medicine Humans Medicine Diagnosis Computer-Assisted Prospective Studies cost – effectiveness anaemia algorithms clinical laboratory information systems Anemia Iron-Deficiency business.industry Biochemistry (medical) Transferrin Workload Original Articles Laboratory results Test (assessment) Vitamin B 12 Chronic disease 030220 oncology & carcinogenesis Ferritins Proper treatment Female Clinical Laboratory Information Systems business Algorithm Algorithms |
| Zdroj: | Biochemia Medica Volume 31 Issue 2 |
| ISSN: | 1846-7482 1330-0962 |
| Popis: | Introduction An appropriate management of anaemia laboratory tests is crucial for a correct diagnosis and treatment. A non-sequential "shotgun" approach (where every anaemia related test is ordered) causes workload and cost increases and could be potentially harmful. We have implemented a Decision Support System through our laboratory information system (LIMS) based on reflexive algorithms and automatic generation of interpretative reports specifically in diagnosis of anaemia for primary care patients. Materials and methods When a request contained an "Anaemia Suspicion Study" profile, more than twenty automatic reflexive rules were activated in our LIMS based upon laboratory results. These rules normally involved the addition of reflexive tests. A final report was automatically generated for each interpretation which was always reviewed for their validity by two staff pathologists. We measured the impact of this system in the ordering of most common anaemia related tests and if a proper treatment was established based on the interpretive report. Results From all the studies performed, only 12% were positive being "iron deficiency" and "anaemia of chronic disease" the most frequent causes, 62% and 17%, respectively. Proper treatment was established in 88% of these anaemic patients. Total iron, transferrin, ferritin, folate and vitamin B12 demand decreased substantially after implementation representing a cost reduction of 40% only for these five tests. Conclusions Our system has easily improved patient outcomes, advising on individual clinical cases. We have also noticeably reduced the number of over-requested tests and laboratory costs. |
| Databáze: | OpenAIRE |
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