An epidemiology-based model as a tool to monitor the outbreak of inappropriateness in tumor marker requests: a national scale study

Clinical Chemistry and Laboratory Medicine : CCLM
Massimo GionAline S C Fabricio

Abstract

Evaluation of appropriateness of laboratory tests on the basis of individual requests remains a serious problem as the clinical question is usually not reported with the test order. This study explored the comparison of the rate of tumor marker orders with cancer prevalence as a putative indicator of inappropriateness. Tumor marker orders (2011 and 2012) were obtained from the Ministry of Health and cancer prevalence from the Italian Association of Cancer Registries. The rate of tumor marker orders was matched with demographic data and tumor prevalence and examined by using the confidence interval approach. Region-to-region and year-to-year variations were also examined. Focus was placed on CEA, CA125, CA19.9 and CA15.3. Tumor markers ordered in Italy were 13,207,289 in 2012 (221.3/1000 individuals). Given an estimated prevalence of 2,243,953 cancer cases, 7.04 tumor markers appear to be requested for each prevalent case of epithelial cancer per year. The rate of requests of CEA, CA125, CA19.9 and CA15.3 (in aggregate 5,834,167 requests in 2012, 44.2% of total) from the first and the last ranked region (96 and 244/1000 individuals) are significantly different (p<0.01). Region-to-region differences do not correspond to any known...Continue Reading

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Citations

May 16, 2017·Journal of Evaluation in Clinical Practice·Massimo GionAline S C Fabricio
Dec 28, 2016·The International Journal of Biological Markers·Massimo Gion
Mar 1, 2017·Biology·Marco TrincheraFabio Dall'Olio
Jun 1, 2017·The International Journal of Biological Markers·Chiara TrevisiolAline S C Fabricio

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Software Mentioned

R
R package ggplot2

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