Inappropriate use of commercial Antinuclear Antibody Testing in a community-based US hospital: a retrospective study. Issue 4 (1st January 2016)

• Record Type: Journal Article
• Authors: Mohammed, Abdul S.; Boddu, Prajwal; Mael, David; Samee, Mohammed; Villines, Dana
• Is Part Of: Journal of community hospital internal medicine perspectives. Volume 6:Issue 4(2016)
• Publication Date: 2016-01-01
• Subjects: antinuclear antibody -- comprehensive antinuclear antibody panel -- rheumatology -- order sets; Internal medicine -- Periodicals; Hospitals -- Periodicals; Hospitals, Community; Internal Medicine; Hospitals; Internal medicine; Periodicals; Periodicals; 610
• DOI: 10.3402/jchimp.v6.32031
• Languages: English
• ISSNs: 2000-9666

Abstract

Abstract : Healthcare providers use antinuclear antibodies (ANAs) to screen and diagnose patients with autoimmune diseases. In the recent years, commercial multiplex ANA kits have emerged as a convenient and fast diagnostic method. Diagnostic testing should follow sequenced algorithms: initial screen followed by specific antibody analysis. Second-level testing as an initial screen for autoimmune disease is inappropriate. We reviewed 68 patients with ANA comprehensive panels over a 6-month period from May 2015 to October 2015. We assessed appropriateness and estimated incurred losses from inappropriate testing. We found 92.6% (63 out of 68) of the ANA comprehensive panel results to be negative. Incurred losses from inappropriate ANA comprehensive panel testing were $66, 000. Physicians should become familiar with ANA-sequenced diagnostic algorithms to avoid unnecessary higher level testing.