scholarly journals Inappropriate laboratory testing requests: perspectives of clinical laboratory professionals

2021 ◽  
Vol 3 (3) ◽  
pp. 249-256
Author(s):  
Sultan Alasmari ◽  

Introduction: Laboratory examinations constitute a major factor in achieving the correct clinical diagnosis for patients. However, the ordering of unnecessary or inappropriate laboratory testing remains common, with consequent consumption of laboratory resources whether human or material. The present work evaluated the level of satisfaction of laboratory practitioners toward the appropriateness of laboratory tests ordered by physicians. Methods: This cross-sectional study involved a total of 256 medical laboratory practitioners representing different qualifications and health care sectors, who answered several questions concerning their knowledge and attitudes toward inappropriate laboratory testing ordered by physicians. Results: More than 85% of respondents agreed with the definition provided in the survey, which is substantially consistent with prior studies. More than 90% affirmed the associated drain on time and resources. However, discrepant responses were received concerning physician awareness of test availability, and participants reported laboratory staff arguments with physicians due to orders for unnecessary tests. Data showed that unnecessary orders were mainly requested by physicians of less experience. Conclusions: Ultimately, dissatisfaction was manifest among clinical laboratory professionals, and educational interventions are required to moderate request behaviors.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simone Canovi ◽  
◽  
Giulia Besutti ◽  
Efrem Bonelli ◽  
Valentina Iotti ◽  
...  

Abstract Background Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. Methods This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2. Results Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation. Conclusions Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.


2020 ◽  
Vol 8 (2) ◽  
pp. e001268
Author(s):  
Angela Koipuram ◽  
Sandra Carroll ◽  
Zubin Punthakee ◽  
Diana Sherifali

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.


Author(s):  
Zayid K. Almayahi ◽  
Fahad Alswaidi ◽  
Abdullah Alzahrani

Abstract Background The established aim of the Saudi Health Electronic Surveillance Network (HESN) is to support the prevention and control of different health events, and to facilitate the delivery of other public health programs. This study aims to evaluate the perceptions of active HESN users regarding its general performance through five major components: practicability, design, data and communication, technical support, and general impression. Methods A cross-sectional study was conducted in 2016 using a sample of active HESN users. Out of 1535 active users, 700 were randomly selected. A predesigned electronic questionnaire was sent to each participant via email which was completed by 485 participants. Different composite scores were calculated and compared to the sociodemographic and other technical variables. Results The mean age of the participants was 36.92 ± 9.12 (24–65 years), and 57.8% of the sample were male. Riyadh and the KSA’s eastern province represented the highest two regions of participation, at (18.4%) and (14.2%) participants, respectively. About 70.8% were generally satisfied with HESN, while 86.6%% believed that it is better than the traditional paper-work system. Participants who used to work more frequently expressed more level of satisfaction compared to those with minimal use per week or month (P ≤ 0.001). Internet speed displayed a significant association with the general level of satisfaction with HESN (P < 0.001). Additionally, users who accessed HESN with the Google Chrome browser displayed higher levels of satisfaction when compared to users who relied on other browsers (P = 0.003). Conclusion Presently, the level of user satisfaction with HESN is reasonable. However, to achieve optimal outcomes for HESN usage, improvements should be considered.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xingrui Wang ◽  
Qinglin Che ◽  
Xiaoxiao Ji ◽  
Xinyi Meng ◽  
Lang Zhang ◽  
...  

Abstract Background Coronavirus disease 2019 (COVID-19) has caused a global pandemic that has raised worldwide concern. This study aims to investigate the correlation between the extent of lung infection and relevant clinical laboratory testing indicators in COVID-19 and to analyse its underlying mechanism. Methods Chest high-resolution computer tomography (CT) images and laboratory examination data of 31 patients with COVID-19 were extracted, and the lesion areas in CT images were quantitatively segmented and calculated using a deep learning (DL) system. A cross-sectional study method was carried out to explore the differences among the proportions of lung lobe infection and to correlate the percentage of infection (POI) of the whole lung in all patients with clinical laboratory examination values. Results No significant difference in the proportion of infection was noted among various lung lobes (P > 0.05). The POI of total lung was negatively correlated with the peripheral blood lymphocyte percentage (L%) (r = − 0.633, P < 0.001) and lymphocyte (LY) count (r = − 0.555, P = 0.001) but positively correlated with the neutrophil percentage (N%) (r = 0.565, P = 0.001). Otherwise, the POI was not significantly correlated with the peripheral blood white blood cell (WBC) count, monocyte percentage (M%) or haemoglobin (HGB) content. In some patients, as the infection progressed, the L% and LY count decreased progressively accompanied by a continuous increase in the N%. Conclusions Lung lesions in COVID-19 patients are significantly correlated with the peripheral blood lymphocyte and neutrophil levels, both of which could serve as prognostic indicators that provide warning implications, and contribute to clinical interventions in patients.


2020 ◽  
Vol 33 (9) ◽  
pp. 1147-1153
Author(s):  
Fatima Ali Mazahir ◽  
Manal Mustafa Khadora

AbstractObjectivesWe evaluated the spectrum of diseases accompanying congenital hypothyroidism (CH) in the United Arab Emirates and compared them with internationally studied patterns.MethodsThe presented retrospective cross-sectional study took place in two government tertiary care centres. In total, 204 patients with a confirmed diagnosis of CH and a minimum period of follow-up of 1 year were included. Patients with Down syndrome, infants born at <35 weeks of gestation, and babies with TORCH (Toxoplasma gondii, Other viruses [HIV, measles, etc.], Rubella, Cytomegalovirus, and Herpes simplex) infections were subsequently excluded from the study.ResultsOf the subjects with CH, 39% had associated extrathyroidal anomalies (ETAs); among these, 25% had a single anomaly. A significant proportion of Arab males were affected by CH as compared to other ethnic groups. Dyshormonogenesis was the commonest aetiological cause (55%) of CH. Males with an ectopic lingual thyroid gland had significant ETAs as compared to females of the same cohort. The most common ETAs were congenital heart disease (16%), followed by urogenital tract anomalies (14%).ConclusionsDetection of a high rate and variability of ETAs associated with CH necessitates the formulation of a structured screening programme including appropriate clinical, laboratory, and imaging tools to detect ETAs at an earlier stage.


2003 ◽  
Vol 127 (8) ◽  
pp. 978-983 ◽  
Author(s):  
Jacqueline M. Seabrook ◽  
Roger A. Hubbard

Abstract Laboratories contemplating either the addition of new molecular tests or modifying methods approved by the Food and Drug Administration for human papillomavirus testing should be aware of a variety of procedural, performance, and regulatory issues surrounding such activity. Diagnostic medical laboratory testing in the United States is regulated by the Centers for Medicare and Medicaid Services, an agency formerly known as the Health Care Finance Administration. The regulatory vehicle of the Centers for Medicare and Medicaid Services is manifested in the Clinical Laboratory Improvement Amendments (CLIA). The CLIA program has put into place specific regulations for laboratory quality control, which includes specific recommendations for method validation. Regulations that must be followed regarding personnel, quality control, quality assurance, method validation, and proficiency testing depend on the complexity category of the individual test. All molecular diagnostic tests, including those for human papillomavirus, are considered high complexity. The Centers for Medicare and Medicaid Services retains the authority to allow private, national accreditation organizations to “deem” that a laboratory is compliant with CLIA '88 requirements. Accreditation organizations, such as the Joint Commission for Accreditation of Hospitals, the Commission on Office Laboratory Accreditation, and the College of American Pathologists (CAP), as well as several state medical laboratory–accrediting agencies, possess the authority to deem laboratories as “CLIA-approved.” The CAP, through its Laboratory Accreditation Program, has promoted standards for laboratory performance and method validation. In general, guidelines set forth in the CAP Laboratory Accreditation Program checklists specify that all clinical laboratory testing must essentially meet those requirements defined for high-complexity testing under CLIA '88, including test validation standards, reportable/reference ranges, performance criteria, and proficiency testing.


2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Magbagbeola D. Dairo ◽  
Salewa Leye-Adebayo ◽  
Abimbola F. Olatule

The availability of accurate, up-to-date, reliable and relevant health information on disease notification by medical laboratory practitioners is essential to detecting and responding to epidemic outbreaks. However, information on notification practices of private laboratory scientists are not well documented. This study was conducted to assess the level of awareness and knowledge of Integrated Diseases Surveillance and Response (IDSR), as well as its practice by private laboratory scientists in Lagos State, Nigeria. In a cross-sectional study, 190 respondents from 14 chapters of the Association of Medical Laboratory Scientists in Lagos state were interviewed using a pretested self-administered semistructured questionnaire to collect information on socio-demographic characteristics, awareness of IDSR and its policy, knowledge of notifiable diseases, practice of IDSR and constraints to reporting notifiable diseases. Data was analyzed using descriptive statistics, Chi-square test and logistic regression at P = 0.05. The mean age of the respondents was 34.0 years with a standard deviation (sd) of ±8.5 years and 65.3% were males. Half (50.0%) of them have ≤5 years of working experience with a mean of 7.5±5.8 years. About 8.9% had ever heard of IDSR. About 9.5% had ever seen a disease notification form and 51.1% had good knowledge of IDSR guidelines for the country. Most (86.3%) had never reported a notifiable disease. Lack of knowledge on how to report (56.8%) and inefficiency of the health department (44.7%) were the major reasons given for not reporting. A significant predictor of disease notification was awareness of IDSR (OR= 5.7, CI=1.9-16.7). Private medical laboratory practitioner’s awareness and practice of disease notification is poor. A range of interventions including awareness campaign, IDSR training, feedback and logistic support for reporting is recommended to improve reporting practices by private medical laboratory scientists.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammed Hammoudeh ◽  
Hanan Al Rayes ◽  
Adel Alawadhi ◽  
Kamel Gado ◽  
Khalid Shirazy ◽  
...  

Data on spondyloarthritis (SpA) from the Middle East are sparse and the management of these diseases in this area of the world faces a number of challenges, including the relevant resources to enable early diagnosis and referral and sufficient funds to aid the most appropriate treatment strategy. The objective was to report on the characteristics, disease burden, and treatment of SpA in the Middle East region and to highlight where management strategies could be improved, with the overall aim of achieving better patient outcomes. This multicenter, observational, cross-sectional study collected demographic, clinical, laboratory, and treatment data on 169 consecutive SpA patients at four centers (Egypt, Kuwait, Qatar, and Saudi Arabia). The data collected presents the average time from symptom onset to diagnosis along with the presence of comorbidities in the region and comparisons between treatment with NSAIDs and biologics. In the absence of regional registries of SpA patients, the data presented here provide a rare snapshot of the characteristics, disease burden, and treatment of these patients, highlighting the management challenges in the region.


2021 ◽  
Vol 10 (34) ◽  
pp. 2874-2878
Author(s):  
Anjana Rathan ◽  
Bijulakshmi P. ◽  
Mathumathi S ◽  
Vikram Ramasubramanian ◽  
Kannan M.

BACKGROUND Telemedicine involving teleconsultation has been a boon to people during this pandemic situation. Safeguarding one against the infection should not put people who are in dire need of medical help feel helpless and desperate. Teleconsultation, which was previously used for people who did not have access to medical help due to geographical isolation, has come to the rescue of people during this pandemic, and sometimes it is the only timely help that is available to people in need. We wanted to measure the patient satisfaction level regarding the use of telemedicine for psychiatric and psychological consultations during the Covid-19 pandemic. METHODS The level of patient satisfaction was measured using the patient experience and satisfaction survey’ proposed (The Research and Development Survey-RANDS) (measuring patient experience and satisfaction to telemedicine, 2020) to measure the level of satisfaction to telemedicine during this pandemic situation, regarding the use of telemedicine for patients who consulted doctors and psychologists in a psychiatric hospital in South India. People who participated filled the questionnaire through google form links sent to them. RESULTS The results indicate that 28 % of people who consulted psychiatrists, recorded scores indicating that they were satisfied with the teleconsultation service, while 71 % of people who consulted psychologists reported being highly satisfied with the consultation. This study indicated that some still preferred direct interaction with psychiatrists as evidenced by 72 % of people feeling dissatisfied with teleconsultation. CONCLUSIONS This study shows that with people struggling with mental illness direct interaction is crucial in the treatment process, however, teleconsultation could be used for emergencies to ensure compliance with medication and for monitoring symptoms in patients. KEY WORDS COVID 19, Teleconsultation, Neuro-Psychiatric Hospital, Patient Satisfaction


Author(s):  
Edison Vitório de Souza Júnior ◽  
Diego Pires Cruz ◽  
Cristiane dos Santos Silva ◽  
Randson Souza Rosa ◽  
Gabriele da Silva Santos ◽  
...  

ABSTRACT Objective: To analyze the association between the experiences of sexuality and quality of life in older adults. Method: Cross-sectional study developed with a total of 300 older adults living in northeastern Brazil. Data collection was carried out entirely online between August and October 2020. Participants completed the online questionnaire containing three instruments for assessing bio sociodemographic data, sexuality and quality of life. Data analysis was performed using the Mann-Whitney, Kruskal-Wallis, Spearman correlation and multivariate linear regression tests, adopting a 95% confidence interval (p < 0.05). Results: Older adults experience better affective relationships and have better quality of life in sensory abilities and intimacy. In the regression analysis, only affective relationships (β = 0.510; [95% CI: 0.340–0.682]; p < 0.001) and physical and social adversities (β = −0.180; [95% CI:−1.443–0.434]; p < 0.001) remained associated with the general quality of life of older adults. Conclusion: Health professionals must invest in training, development of individual and group educational interventions, in addition to promoting the strengthening of bonds between older adults so that they feel free and comfort in expressing their intimate needs.


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