Abstract
Although the issue of monitoring appropriateness of tumour markers (TMs) request in outpatients remains crucial, proper indicators are still demanding. The present study developed and explored indicators of inappropriate TM ordering in outpatients through the data mining of electronic health records (EHRs). Carcinoembryonic antigen (CEA), alfa-fetoprotein (AFP), carbohydrate antigen (CA)125, CA15.3, CA19.9, and prostate-specific antigen (PSA) ordered in outpatients during a year were examined by mining EHRs of a Local Health Authority in Italy. Evidence-based criteria were used to develop performance indicators. Demographic and clinical information associated with TM orders were examined. A total of 80 813 TMs were ordered in 52 536 outpatients (1.54 markers/patient). Indicators related to disease codes, gender, age, and TM repetitions were developed, and their application showed that (1) CA15.3 and CEA are prevalently requested in patients with cancer (79.2% and 65.6%) whereas the other TMs are largely requested also in patients without cancer; (2) requests of PSA in women and of CA125 or CA15.3 in men are negligible; (3) although requests in people older than 80 years are relevant (16.4% of total), the highest rate of request...Continue Reading
References
May 5, 1998·American Journal of Preventive Medicine·E A McGlynn, S M Asch
Aug 26, 1998·JAMA : the Journal of the American Medical Association·C van Walraven, C D Naylor
Mar 8, 2000·American Journal of Clinical Pathology·H T PoteatD W Bates
Dec 7, 2002·Quality & Safety in Health Care·S M CampbellM Marshall
May 15, 2003·JAMA : the Journal of the American Medical Association·Wim H J M VerstappenRichard P T M Grol
Dec 20, 2003·Clinical Chemistry·Peter S Bunting, Carl Van Walraven
Oct 16, 2004·Internal Medicine Journal·S LoiH G Schneider
May 1, 2008·Journal of General Internal Medicine·Douglas S BellCarol M Mangione
Oct 17, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·D PapamichaelUNKNOWN SIOG
Jun 3, 2009·Annals of Clinical Biochemistry·Roberta FranceschiniMassimo Gion
May 6, 2010·Journal of the American Medical Informatics Association : JAMIA·Steven J Steindel
Apr 4, 2012·The Lancet Oncology·Laura BiganzoliRiccardo Audisio
May 3, 2012·Nature Reviews. Genetics·Peter B JensenSøren Brunak
Sep 28, 2012·Journal of Clinical Pathology·Anthony A Fryer, W Stuart A Smellie
Jun 28, 2013·BMJ : British Medical Journal·Grammati SarriUNKNOWN Guideline Development Group
Nov 22, 2013·PloS One·Ming ZhiRamy Arnaout
Mar 19, 2014·BJU International·Nicolas MottetSteven Joniau
Jul 2, 2014·PLoS Medicine·Ray MoynihanKarel G M Moons
Jul 3, 2015·BioMed Research International·Emilie BaroEmmanuel Chazard
Sep 10, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Massimo GionAline S C Fabricio
Feb 5, 2016·Biomedical Informatics Insights·Jake LuoYiqing Zhao
Dec 28, 2016·The International Journal of Biological Markers·Massimo GionAline S C Fabricio
Mar 4, 2017·The International Journal of Biological Markers·Massimo GionAline S C Fabricio