Application of hepatitis serology testing algorithms to assess inappropriate laboratory utilization

ÖZBEK Ö. A., Oktem M., Dogan G., Abacioglu Y.

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, vol.10, no.4, pp.519-523, 2004 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 10 Issue: 4
  • Publication Date: 2004
  • Doi Number: 10.1111/j.1365-2753.2003.00447.x
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.519-523
  • Keywords: algorithms, diagnostic tests, forms and records control, unnecessary procedures, utilization review, GUIDELINE, DESIGN
  • Dokuz Eylül University Affiliated: Yes


Rationale, aims and objectives Many studies pointed out inappropriate utilization of laboratory caused by excessive amounts of tests ordered by doctors. To prevent and to eliminate the ordering of unhelpful tests, introducing diagnostic algorithms, which are also a suitable practice for application to hepatitis serology, have been suggested. This study aimed to determine inappropriate test ordering rates with respect to the commonly approved algorithms for serological diagnosis of viral hepatitis. Methods To assess the number of inappropriate test orders, laboratory records of samples sent for hepatitis A, B, and D serology were reviewed and evaluated retrospectively with respect to algorithms for serological diagnosis of viral hepatitis. Orders including serological marker groups with inadequate clinical information to determine whether or not the order was inappropriate were excluded from the analysis. Results Application of diagnostic algorithms showed that 50% of anti-HAV IgM and anti-HAV total; 12.7% of anti-HBs, 12.7% of anti-HBc total, 78.5% of anti-HBc IgM, 87.3% of HBe Ag, 78.8% of anti-HBe, 58.7% of anti-HD total orders were made inappropriately. Conclusions Our study provides information for inappropriate laboratory utilization for hepatitis serology testing and we suggest to use diagnostic algorithms applied by the serology laboratory to decrease the rate of unhelpful test orders.