Abstract：
INTRODUCTION:The avoidance of repeat chemistry testing such as Complete Blood Count (CBC) and Electrolyte Panel (EP) on clinically stable patients was identified as important utilization goals by Choosing Wisely Canada. The purpose of this study was to assess the volume of overutilization of CBC and EP in an inpatient setting in Alberta, Canada, and provide an estimated cost assessment of unnecessary testing. METHODS:The total laboratory testing volumes of two common test panels were collected retrospectively for one-year from January to December 2018. Data was collected on test panels performed in an emergency room (ER) and inpatient setting from three separate Laboratory Information Systems covering the provincial population in Alberta, Canada. Total initial test panel instances, total repeated panels, repeated panels that were previously normal or abnormal, and estimated costs were examined. Cost assessment was completed based on Reference Median Cost (RMC) analysis for each of these two common test panels. RESULTS:During the study period, 2,020,467 (CBC) and 1,455,983 (EP) initial test panel instances were recorded, of which 67.7% and 73.5% were repeated for the CBC and EP, respectively. There was a higher proportion of EP repeated inappropriately (previously normal; 35.6%) compared to CBCs (5.4%). The cost to the province for inappropriately repeating CBC and EP were estimated to be RMC $0.52 million and RMC $1.90 million CAD, respectively. CONCLUSION:Results from this study can assist policy makers in implementing utilization management initiatives and update clinical practice guidelines to reduce costs to healthcare without compromising patient care.
journal_name
Clin Biochemjournal_title
Clinical biochemistryauthors
Kandalam V,Lau CK,Guo M,Ma I,Naugler Cdoi
10.1016/j.clinbiochem.2019.12.011subject
Has Abstractpub_date
2020-03-01 00:00:00pages
32-35eissn
0009-9120issn
1873-2933pii
S0009-9120(19)31027-6journal_volume
77pub_type
杂志文章abstract：OBJECTIVES:To evaluate platelet activating factor (PAF) levels, its metabolic enzymes activity and its associations with other inflammatory markers in heart failure (HF) patients. DESIGN AND METHODS:PAF, and two of its key biosynthetic enzymes [lyso-PAF acetyltransferase (lyso-PAF-AT) and DTT-insensitive CDP-choline:1...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2008.09.113
更新日期：2009-01-01 00:00:00
abstract：OBJECTIVES:To investigate the association between oxidative stress and certain trace elements in the blood of breast cancer patients. DESIGN AND METHODS:Malondialdehyde (MDA) was measured in serum of patients with breast cancer (n = 35) and controls (n = 35) by high performance liquid chromatography. Trace elements we...
journal_title：Clinical biochemistry
pub_type： 临床试验,杂志文章
doi：10.1016/s0009-9120(98)00096-4
更新日期：1999-03-01 00:00:00
abstract：OBJECTIVES:Current extraction methods for cobalamins from serum influence the molecular characteristics of the vitamin. Therefore, an extraction procedure that leaves the cobalamins unchanged is needed. DESIGN AND METHODS:Monoclonal antibodies towards transcobalamin (TC) and haptocorrin (HC) (in house) linked to magne...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2007.09.008
更新日期：2007-12-01 00:00:00
abstract：:A spectrophotometric study was carried out for three proteins assays when modification of their serum procedures using bromcresol green, bromcresol purple and biuret reagents were applied to the determinations of total proteins and albumin in cerebrospinal fluids. A novel concentration device wherein the sample itself...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/0009-9120(81)90165-x
更新日期：1981-02-01 00:00:00
abstract：OBJECTIVES:: To test if circulating forms of the soluble urokinase-type plasminogen activator receptor (suPAR) are potential biomarkers of plaque vulnerability. DESIGN AND METHODS:: Plasma concentrations of suPAR(I-III), suPAR(II-III) and uPAR(I) were measured by time-resolved fluorescence immunoassays in Caucasian pa...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2009.09.028
更新日期：2010-01-01 00:00:00
abstract：:Fibroblast growth factor 23 (FGF-23), a key hormone for the regulation of the phosphorus homeostasis, has also several direct effects on cardiac function. In heart failure (HF), the increase of FGF-23 participates to cardiac hypertrophy and remodeling. Measurement of the intact, biologically active hormone is now avai...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2018.09.003
更新日期：2018-11-01 00:00:00
abstract：OBJECTIVES:Oxidative stress has a clear pro tumoral effect in myeloproliferative neoplasms (MPDs). In this study, we analyzed oxidative stress in patients with essential thrombocythemia (ET) and polycythemia vera (PV). Design and methods We analyzed serum levels of advanced oxidation protein products (AOPPs) degradatio...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2012.07.100
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVES:Measurement of serotonin concentrations in blood is considered to be important for the clinical studies of diseases involving vascular endothelial injury. We have developed a high-performance liquid chromatographic (HPLC) method for measurement of serotonin level in platelet-poor plasma (PPP). METHODS:Venou...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2003.11.009
更新日期：2004-03-01 00:00:00
abstract：OBJECTIVES:We sought to investigate whether heart-type fatty acid binding protein (H-FABP), a new marker of myocardial necrosis, increases in relation to elective cardioversion of atrial fibrillation (AF). METHODS:We studied 25 consecutive patients (61 ± 16 years old, 21 men) admitted to our hospital for elective card...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2011.05.029
更新日期：2011-08-01 00:00:00
abstract：OBJECTIVES:Accurate measurement of IgG subclass (IgGSc) levels are essential to aid in the diagnosis of disease states such as primary immunodeficiencies. However, there is no single standardisation of nephelometric and turbidimetric assays for these analytes and two reference materials have been utilised. We expand on...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2013.07.014
更新日期：2013-11-01 00:00:00
abstract：:A simple and rapid method for serum sex hormone binding globulin (SHBG) was developed. Sera from pregnant women were pooled and the SHBG concentration was measured by Rosner's method. This pool was diluted with charcoal-treated and heated serum to give standards ranging in concentrations from 26.8-0.8 micrograms/L. Tw...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(85)80031-x
更新日期：1985-10-01 00:00:00
abstract：:A retrospective study has been undertaken to assess the diagnostic value of plasma estriol (E3) determinations, as compared with determinations of other biochemical parameters, in predicting the outcome of pregnancy. The normal levels of plasma unconjugated and total E3 were determined on weekly samples obtained durin...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(81)90211-3
更新日期：1981-06-01 00:00:00
abstract：OBJECTIVES:To investigate the association of parental hyperhomocysteinemia, C677T Methylene tetrahydrofolate reductase (MTHFR) polymorphism and DNA damage with recurrent pregnancy loss (RPL). DESIGN AND METHODS:A case-control study. Reverse phase HPLC, PCR-RFLP and Cytokinesis blocked micronuclei assay were used to as...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2008.12.003
更新日期：2009-03-01 00:00:00
abstract：OBJECTIVES:We determined the relationship of smoking status on APOC3 -482C>T polymorphism and apolipoprotein C-III (apoC-III) concentrations and the latter two parameters' influence on risk of diabetes and coronary heart disease (CHD). DESIGN AND METHODS:Prediction of incident cases was assessed at 5.5years' follow-up...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2010.12.009
更新日期：2011-04-01 00:00:00
abstract：OBJECTIVES:The ratio of glycated albumin to HbA1c (GA/HbA1c ratio) is a known indicator that reflects fluctuations in plasma glucose. In this study, the association of the GA/HbA1c ratio to diabetic nephropathy and diabetic retinopathy in patients with type 2 diabetes was investigated. DESIGN AND METHODS:Among patient...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2016.11.032
更新日期：2017-04-01 00:00:00
abstract：OBJECTIVES:Analysis of serum/plasma methylmalonic acid (MMA) is important for the diagnosis and management of methylmalonic acidemia in pediatric populations. This work focuses on developing and validating a liquid chromatography tandem mass spectrometry (LC-MS/MS) method to monitor methylmalonic acidemia using a simpl...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2016.05.010
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:We used single-strand conformational polymorphism (SSCP) to screen for mutations at nucleotides 833 and 919 of the cystathionine beta-synthase (CBS) gene in 13 patients with homocystinuria and 11 of their relatives. METHODS:Exon 8 of genomic DNA was selectively amplified by PCR using primers derived from int...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/0009-9120(96)00045-8
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVES:We have comparatively evaluated respiratory burst and some steps of its signaling in human granulocytes towards different stimuli. MATERIALS AND METHODS:An alternative method to remove erythrocytes by dextran differential sedimentation was employed. Respiratory burst (RB) was assessed in a flow cytometer by...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2005.10.005
更新日期：2006-01-01 00:00:00
abstract：OBJECTIVES:Oxidative stress plays a role in the pathogenesis in patients with HCV infection. The objective of this study was to evaluate oxidant and antioxidant biomarkers in patients with HCV. DESIGN AND METHODS:Serum malonaldehyde (MDA) and nitric oxide (NO) levels and the activities of myeloperoxidase (MPO), aryles...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2009.06.007
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVES:Sphingosine 1-phosphate (S1P) is carried in plasma by the HDL particles and albumin. It mediates several protective functions of HDL. Because of its barrier-enhancing effect, it has attracted attention in diseases associated with endothelial dysfunction. We examined the impact of circulating levels of S1P in...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2015.08.001
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVES:End-stage renal disease (ESRD) is characterized by profound dyslipidemia and enhanced oxidative stress. The patients also show evidence of exhausted and/or deficient anti-oxidative defense enzymes, one of them being glutathione-S-transferase (GST). This study investigates relationship between GST gene polymo...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2013.11.011
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVES:An overview of biochemical markers of bone metabolism is presented along with indications for their clinical utilization. DESIGN AND METHODS:The structure, cyclical metabolism, and hormone regulation of bone is reflected by markers of resorption, formation and/or turnover. Markers of resorption representing...
journal_title：Clinical biochemistry
pub_type： 杂志文章,评审
doi：10.1016/s0009-9120(97)00113-6
更新日期：1997-12-01 00:00:00
abstract：OBJECTIVES:Carbonylation of the protein amino, guanidino and thiol groups is one of the important causes of vascular complications in diabetes. We developed a simple spectrophotometric method for monitoring of the changes in the protein amino group contents during carbonylation. DESIGN AND METHODS:The method is based ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2011.05.019
更新日期：2011-08-01 00:00:00
abstract：OBJECTIVES:The aim of the study was to evaluate the concentration of interleukin 12 (IL-12), the activity of phospholipase A(2) (PLA(2)), and platelet-activating factor acetylhydrolase (PAF-AH) in type 1 diabetes (DM1) patients treated with intensive insulin therapy. DESIGN AND METHODS:Studied parameters were measured...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2009.07.023
更新日期：2009-11-01 00:00:00
abstract：:Enzymic fluorimetric methods are described for the determination of primary bile acids and of chenodeoxycholic acid (CDC) and cholic acid (C) in serum. Bile acids are extracted from 0.3 mL of serum in a simple 5-min step with use of Sep-Pak C cartridges. Total primary bile acids are measured by an equilibrium techniqu...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(84)90145-0
更新日期：1984-08-01 00:00:00
abstract：OBJECTIVE:This article will review the advancements and new developments being made in (1) advanced computers, (2) microtechnology, (3) advanced immunodiagnostics, (4) neural networks, and (5) molecular biology. The influence of these technologies and their products on clinical laboratories is also discussed. CONCLUSI...
journal_title：Clinical biochemistry
pub_type： 杂志文章,评审
doi：10.1016/0009-9120(94)00075-7
更新日期：1995-06-01 00:00:00
abstract：:A non-isotopic heterogeneous non-competitive immunoassay for carcinoembryonic antigen is described. CEA present in serum binds simultaneously to two monoclonal antibodies specific for different antigenic determinants of CEA. One antibody is immobilized on a solid-phase (microtiter well) and the other is biotinylated. ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(89)80094-3
更新日期：1989-12-01 00:00:00
abstract：:An affinity chromatographic method (AC) was compared with ion exchange chromatography (IEC) for determination of glycated hemoglobin (gHb). In vitro, increasing glucose concentration produced no change on AC-determined gHb. gHb measurement by AC was highly correlated with mean blood glucose (r = 0.96). Mean values of ...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(86)80010-8
更新日期：1986-12-01 00:00:00
abstract：OBJECTIVES:Although numerous recent studies have focused on analyses of microRNA expression profiles in cancer cells, the expression patterns of the enzymes responsible for the generation of miRNAs remains largely unexplored. The purpose of this study was to investigate whether Dicer mRNA expression is altered during p...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/j.clinbiochem.2009.09.014
更新日期：2010-02-01 00:00:00
abstract：:An ion-exchange chromatographic procedure is described which facilitates the determination of beta-chain aminoterminal modified glycated hemoglobin. The procedure includes an erythrocyte lysis reagent which eliminates the labile aldimine component (pre-A1c) and a two-stage elution step which separates HbA, 1a + b from...
journal_title：Clinical biochemistry
pub_type： 杂志文章
doi：10.1016/s0009-9120(85)80020-5
更新日期：1985-02-01 00:00:00
