scholarly journals Is the Climb Worth the View? The Savings/Alert Ratio for Reducing Vitamin D Testing

2020 ◽  
Vol 11 (01) ◽  
pp. 160-165
Author(s):  
Chase D. Hendrickson ◽  
Michael F. McLemore ◽  
Kathryn M. Dahir ◽  
Shari Just ◽  
Zahra Shajani-Yi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Medical Center ◽  
Intervention Group ◽  
Clinical Decision ◽  
Control Group ◽  
Hydroxyvitamin D ◽  
Patient Demographics ◽  
25 Hydroxyvitamin D ◽  
A Charge ◽  
The Impact

Abstract Background Despite guideline recommendations, vitamin D testing has increased substantially. Clinical decision support (CDS) presents an opportunity to reduce inappropriate laboratory testing. Objectives and Methods To reduce inappropriate testing of vitamin D at the Vanderbilt University Medical Center, a CDS assigned providers to receive or not receive an electronic alert each time a 25-hydroxyvitamin D assay was ordered for an adult patient unless the order was associated with a diagnosis in the patient's chart for which vitamin D testing is recommended. The CDS ran for 80 days, collecting data on number of tests, provider information, and basic patient demographics. Results During the 80 days, providers placed 12,368 orders for 25-hydroxyvitamin D. The intervention group ordered a vitamin D assay and received the alert for potentially inappropriate testing 2,181 times and completed the 25-hydroxyvitamin D order in 89.9% of encounters, while the control group ordered a vitamin D assay (without receiving an alert) 2,032 times and completed the order in 98.1% of encounters, for an absolute reduction of testing of 8% (p < 0.001). Conclusion This CDS reduced vitamin D ordering by utilizing a soft-stop approach. At a charge of $179.00 per test and a cost to the laboratory of $4.20 per test, each display of the alert led to an average reduction of $14.70 in charges and of $0.34 in spending by the laboratory (the savings/alert ratio). By describing the effectiveness of an electronic alert in terms of the savings/alert ratio, the impact of this intervention can be better appreciated and compared with other interventions.

scholarly journals Effect of vitamin D supplementation on serum 25-hydroxyvitamin D concentration in children and adolescents: a systematic review and meta-analysis protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021636 ◽  
Author(s):  
Golaleh Asghari ◽  
Hossein Farhadnejad ◽  
Farhad Hosseinpanah ◽  
Nazanin Moslehi ◽  
Parvin Mirmiran ◽  
...  
Keyword(s):  
Vitamin D ◽  
Children And Adolescents ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Placebo Control ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
The Impact

IntroductionThe importance of vitamin D for bone health as well as its role in non-skeletal functions has long been documented. However, review investigations on the effect of vitamin D supplementation on serum 25-hydroxyvitamin D (25(OH)D) levels in children and adolescents are scarce. The aims of the current study were to assess the impact of various doses of vitamin D supplementation on serum 25(OH)D concentrations in children and adolescents, and to identify relevant determinants of variations in the effect of vitamin D supplementation.MethodsPubMed, Scopus, ISI Web of Science and Cochrane Central Register of Controlled Trials databases up to 27 September 2017 will systematically be searched for randomised controlled trials of vitamin D supplementation. We considered articles with the following control groups as eligible: placebo control, control group without any supplementation or a comparative arm investigation. Two reviewers will assess articles for eligibility according to prespecified selection criteria, after which data extraction and quality appraisal will be conducted by two independent reviewers. The quality assessment will be assessed using the Jadad scale. Meta-analyses will be conducted where appropriate. We will express continuous measures (ie, serum 25(OH)D concentration) as mean differences with 95% CIs. Heterogeneity of the data will be investigated via visual inspection of the forest plots and using χ2test on N-1 df, with a significance level of α=0.1. We will also assess individual study and subgroup characteristics and perform a sensitivity analysis. Publication bias will be assessed using funnel plot and statistical analysis of Egger’s test.Ethics and disseminationEthics approval is not required because the work will be carried out on published documents. The authors will publish findings from this review through peer-reviewed publication or conference presentations.PROSPERO registration numberCRD42017067179.

scholarly journals Association between vitamin D and uterine fibroids: a study protocol of an open-label, randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038709
Author(s):  
Bo Sheng ◽  
Yizuo Song ◽  
Yi Liu ◽  
Chenchen Jiang ◽  
Xueqiong Zhu
Keyword(s):  
Clinical Trial ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Intervention Group ◽  
Uterine Fibroids ◽  
Vitamin D Insufficiency ◽  
Control Group ◽  
Open Label ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

IntroductionUterine fibroids are the most common pelvic benign tumour with no satisfactory long-term medical treatment. Recent studies have demonstrated that vitamin D significantly inhibited the growth of fibroids in vitro, vivo and a small-sample clinical trial. Therefore, the aim of this randomised clinical trial (RCT) is to evaluate whether supplementation with vitamin D could reduce the risk and inhibit the growth of uterine fibroids in reproductive stage women.Methods and analysisThe open-label, RCT comprises two parts, including parts I and II. In part I, 2230 vitamin D deficiency or vitamin D insufficiency patients without uterine fibroids will be randomly assigned to two groups: intervention group (according to the level of serum 25-hydroxyvitamin D3, receive 1600 or 800 IU/day of vitamin D3 for 2 years) and control group (followed up at the same time points). By using gynaecological ultrasound examinations, the incidence of uterine fibroids will be employed to measure the outcome in different groups. In part II, 360 uterine fibroids patients with vitamin D deficiency or vitamin D insufficiency will be randomly assigned to intervention group or control group. According to the level of serum 25-hydroxyvitamin D3, 180 patients will receive 1600 or 800 IU/day of vitamin D3 for 2 years. Control group will receive regular follow-up. The outcome measure will be conducted using gynaecological ultrasound examinations to detect the growth of uterine fibroids in each group.Ethics and disseminationThis study has been approved by the institutional review board of the Second Affiliated Hospital of Wenzhou Medical University (No. LCKY2018-35).Trial registration numbersNCT03586947 and NCT03584529.

Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome

2019 ◽  
pp. 68-73
Author(s):  
Trong Nghia Nguyen ◽  
Thi Nhan Nguyen ◽  
Thi Dua Dao
Keyword(s):  
Metabolic Syndrome ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Control Group ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
The Metabolic Syndrome ◽  
25 Hydroxyvitamin D ◽  
Key Words Metabolic Syndrome ◽  
And Control

Background: The metabolic syndrome is a constellation of cardiometabolic risk factors that tend to cluster together in affected individuals more often than predicted by chance. The presence of the metabolic syndrome substantially increases the risk of developing type 2 diabetes and cardiovascular disease, and is associated with a range of adverse clinical outcomes, many of which are closely associated with aging. Current estimates suggest that approximately 20 - 25% of the world’s population is affected by the metabolic syndrome. The prevalence of the metabolic syndrome rises with age and more than 45% of people aged over 60 years have the metabolic syndrome. Recent studies show that low vitamin D status is very common in the world and this is a risk factor of metabolic syndrome. Objective: (1) Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome. (2) Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Material and method: A cross-sectional study with control group on 318 adult subjects for health examinations at International Medical Center at Hue Central Hospital, including 139 subjects with metabolic syndrome and control group of 179 healthy subjects. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Plasma hydroxyvitamin D concentration was measured using chemiluminescent microparticle immunoassay. Reciever operating characteristic (ROC) curve were generated to assess sensitivity and specificity for different cut off value of 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Results: Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome was 26.4 ng/ml, incidence of plasma 25-hydroxyvitamin D deficiency (59.7%) was significantly higher than in control group (23.5%) (p < 0.001). The optimal cut off point for 25-OH-D concentration for predictor of metabolic syndrome as 26.4 ng/ml (AUC=0.657, sensitivity=53.4%, specificity=71.6%). Conclusion: In 139 subjects with metabolic syndrome, the plasma 25-hydroxyvitamin D concentration was 26.4 ng/ml and the incidence of 25-hydroxyvitamin D deficiency in the metabolic syndrome group was 59.7%. The optimal cut off point for plasma 25-hydroxyvitamin D concentration for predictor of metabolic syndrome as 26.4 ng/ml. Key words: Metabolic syndrome, 25-hydroxyvitamin D

scholarly journals Weight and skin colour as predictors of vitamin D status: results of an epidemiological investigation using nationally representative data

2016 ◽  
Vol 20 (10) ◽  
pp. 1857-1864 ◽  
Author(s):  
Sonali Rajan ◽  
Tom Weishaar ◽  
Bryan Keller
Keyword(s):  
Vitamin D ◽  
Body Weight ◽  
Skin Colour ◽  
Vitamin D Status ◽  
Epidemiological Investigation ◽  
Dietary Recommendations ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Nationally Representative ◽  
The Impact

AbstractObjectiveCurrent US dietary recommendations for vitamin D vary by age. Recent research suggests that body weight and skin colour are also major determinants of vitamin D status. The objective of the present epidemiological investigation was to clarify the role of age as a predictor of vitamin D status, while accounting for body weight and skin colour, among a nationally representative sample.DesignWe calculated the mean serum 25-hydroxyvitamin D levels for the US population by age and weight, as well as by weight and race/ethnicity group. Multiple regression analyses were utilized to evaluate age and weight as predictors of vitamin D status: serum 25-hydroxyvitamin D levels with age alone, age and body weight, and age, body weight and their two-way interaction were modelled for the entire sample and each age subgroup. Graphical data were developed using B-spline non-linear regression.SettingNational Health and Nutrition Examination Survey (31 934 unweighted cases).SubjectsIndividuals aged 1 year and older.ResultsThere were highly significant differences in mean vitamin D status among US residents by weight and skin colour, with those having darker skin colour or higher body weight having worse vitamin D status. Although a significant factor, the impact of age on vitamin D status was notably less than the impact of body weight.ConclusionsVitamin D status varied predominantly by body weight and skin colour. Recommendations by nutritionists for diet and supplementation needs should take this into account if vitamin D-related health disparities are to be meaningfully reduced across the USA.

scholarly journals Five salmon dinners per week were not sufficient to prevent the reduction in serum vitamin D in autumn at 60° north latitude: a randomised trial

2019 ◽  
Vol 123 (4) ◽  
pp. 419-427 ◽  
Author(s):  
Marianne Bratlie ◽  
Ingrid V. Hagen ◽  
Anita Helland ◽  
Øivind Midttun ◽  
Arve Ulvik ◽  
...  
Keyword(s):  
Vitamin D ◽  
Fish Intake ◽  
Control Group ◽  
Serum Concentrations ◽  
Hydroxyvitamin D ◽  
Western Norway ◽  
Increased Risk ◽  
25 Hydroxyvitamin D ◽  
High Fish ◽  
North Latitude

AbstractLow serum concentrations of several vitamins have been linked to increased risk of diseases including insulin resistance and type 2 diabetes (T2D). Fish is a good source of several vitamins, and the prevalence of T2D is low in populations with high fish intake. The aim of the present study was to investigate the effects of high fish intake on vitamins in serum from adults in autumn in South-Western Norway at 60° north latitude. In this randomised clinical trial, sixty-three healthy participants with overweight/obesity consumed 750 g/week of either cod (n 22) or salmon (n 22) as five weekly dinners or were instructed to continue their normal eating habits but avoid fish intake (Control group, n 19) for 8 weeks. The estimated vitamin D intake was significantly increased in the Salmon group when compared with the Cod group (P = 6·3 × 10−4) and with the Control group (P = 3·5 × 10−6), with no differences between groups for estimated intake of vitamins A, B1, B2, B3, B6, B9, C and E. Serum 25-hydroxyvitamin D3 concentration was decreased in all groups after 8 weeks; however, the reduction in the Salmon group was significantly smaller compared with the Cod group (P = 0·013) and the Control group (P = 0·0060). Cod and salmon intake did not affect serum concentrations of the other measured vitamins. The findings suggest that 750 g/week of salmon was not sufficient to prevent a decrease in serum 25-hydroxyvitamin D3 in autumn in South-Western Norway in adults with overweight/obesity.

scholarly journals The impact of vitamin D pathway genetic variation and circulating 25-hydroxyvitamin D on cancer outcome: systematic review and meta-analysis

2017 ◽  
Vol 116 (8) ◽  
pp. 1092-1110 ◽  
Author(s):  
P G Vaughan-Shaw ◽  
F O'Sullivan ◽  
S M Farrington ◽  
E Theodoratou ◽  
H Campbell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Genetic Variation ◽  
Meta Analysis ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Cancer Outcome ◽  
The Impact

scholarly journals Serum vitamin D content in children with SARS-CoV-2 infection

2021 ◽  
Vol 6 ◽  
pp. 79-82
Author(s):  
V.N. Peregoedova ◽  
◽  
I.K. Bogomolova ◽  
Keyword(s):  
Vitamin D ◽  
Serum Level ◽  
Clinical Symptoms ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Control Group ◽  
Immunochemical Method ◽  
Hydroxyvitamin D ◽  
Serum Vitamin D ◽  
25 Hydroxyvitamin D

Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and мethods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22; 28.07] ng/ml) as compared with the control group (36.43 [32.05; 44.08] ng/ml; p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.

scholarly journals Maternal Serum 25-Hydroxy Vitamin D Concentrations and Calcium Levels in Preeclamptic Women, Sindh, Pakistan

2021 ◽  
pp. 216-221
Author(s):  
Khalil Ahmed Memon ◽  
Hazoora Shaikh ◽  
Rukhsana Soomoro ◽  
Yasmeen Joyo ◽  
Saira Parveen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Multinomial Logistic Regression ◽  
Serum Vitamin ◽  
Maternal Serum ◽  
Control Group ◽  
Case Group ◽  
Hydroxyvitamin D ◽  
Serum Vitamin D ◽  
25 Hydroxyvitamin D

Objectives: To analyse the levels of serum 25-hydroxyvitamin D 25(OH) Dand calcium concentrations in patients with pre-eclampsia, Hyderabad, Sindh, Pakistan. Methodology: Cross sectional study was conducted at the Gynaecology and Obstetrics Department, LUHS, Hyderabad during the period of January 2020 to June 2020. Total 150 pregnant women were selected according to predesign Proforma and divided into two groups. 50 females were normal normotensive pregnant women as a control group, 100 were pre-eclamptic patients as case group. Obstetric history, clinical data was gathered and then 5ml of blood sample was collected from each patient. The blood samples were taken for the analysis of 25-hydroxyvitamin D or 25(OH)D and calcium levels. 25(OH)D were performed on chemiluminescence, While calcium concentration of Microlab 300. Data was analysed by using SPSS version 23. Student t-test was used for analysed of continuous variables. Results: The maternal serum vitamin D and calcium levels were significantly decreased as compared to patient with preeclampsia and normotensive healthy pregnant ladies. The blood pressure also declined in case group with P<0.001.Multinomial logistic regression showed significant odd ratio of Vitamin-D and Calcium deficiency in preeclampsia. Conclusion: The present study reveals that 25-hydroxyvitamin D, and Calcium levels declined significantly in preeclamptic women, and mighty be biomarker of this life threating disease.

scholarly journals The Impact of Sample Type on Vitamin D Quantification and Clinical Classification during Pregnancy

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3872
Author(s):  
Soriah M. Harvey ◽  
Vanessa E. Murphy ◽  
Peter G. Gibson ◽  
Michael Clarke ◽  
Megan E. Jensen
Keyword(s):  
Vitamin D ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Plasma Concentrations ◽  
Sample Type ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
Significant Difference ◽  
25 Hydroxyvitamin D ◽  
The Impact

Measurement of vitamin D status has significant use in clinical and research settings, including during pregnancy. We aimed to assess the agreement of total 25-hydroxyvitamin D (25(OH)D) concentration, and its three analytes (25-hydroxyvitamin D3 (25(OH)D3), 25-hydroxyvitamin D2 (25(OH)D2) and Epi-25-hydroxyvitamin D3 (Epi-25(OH)D3)), in plasma and serum samples collected during pregnancy, and to examine the proportion of women who change vitamin D status category based on sample type. Matching samples were collected from n = 114 non-fasting women between 12–25 weeks gestation in a clinical trial in Newcastle, Australia. Samples were analysed by liquid chromatography-tandem mass-spectrometry (LC-MS/MS) to quantify total 25(OH)D and its analytes and examined using Bland-Altman plots, Pearson correlation (r), intraclass correlation coefficient and Cohen’s Kappa test. Serum total 25(OH)D ranged from 33.8–169.8 nmol/L and plasma ranged from 28.6–211.2 nmol/L. There was a significant difference for total 25(OH)D based on sample type (measurement bias 7.63 nmol/L for serum vs plasma (95% Confidence Interval (CI) 5.36, 9.90, p ≤ 0.001). The mean difference between serum and plasma concentrations was statistically significant for 25(OH)D3 (7.38 nmol/L; 95% CI 5.28, 9.48, p ≤ 0.001) and Epi-25(OH)D3 (0.39 nmol/L; 95% CI 0.14, 0.64, p = 0.014). Of 114 participants, 28% were classified as vitamin D deficient (<50 nmol/L) or insufficient (<75 nmol/L) based on plasma sample and 36% based on serum sample. Nineteen (16.7%) participants changed vitamin D status category based on sample type. 25-hydroxyvitamin D quantification using LC-MS/MS methodology differed significantly between serum and plasma, yielding a higher value in plasma; this influenced vitamin D status based on accepted cut-points, which may have implications in clinical and research settings.

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