Research article: Evaluation of Laboratory Test Ordering Practices for Patients Suspected of anti-Glomerular Basement Membrane Disease
Clare Shea, Julie Soder, Juan U Rojo, Janet Enderle, Rajkumar Rajendran
Background: The objective of this study was to evaluate the laboratory test ordering practices for patients suspected of anti-glomerular basement membrane (anti-GBM) disease at an academic teaching hospital.
Methods: A retrospective cross-sectional study was conducted using data from EPIC electronic medical records (EMR) system from January of 2013 to January of 2022 on patients suspected of anti-GBM disease. Data collected include patient demographics, medical history, and laboratory test results. Patient data was stratified and analyzed using SPSS statistical software version 28.
Results: From the total 110 patients analyzed in this study; 42.7% (n=47) patients did not have an anti-GBM test ordered appropriately. Analysis of patient demographics revealed most of the patients were female (54.5%, (n=60)) and white (73.6%, (n=81)) non-Hispanic or Latino (69.1%, n=76)). Regarding type of anti-GBM serology tests, in the appropriate group, 41.3% (n=26 out of 63) of patients had both an enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody (IFA) test performed, while the inappropriate group 57.4% (n=27 out of 47) of patients had only an ELISA test ordered. There was a significant difference observed in serum creatinine (p= 0.003) and estimated glomerular filtration rate (eGFR) (p=0.011) for patients who had an anti-GBM test ordered appropriately.
Conclusions: The opportunities for quality improvement identified in this study can be used to implement a test ordering algorithm for anti-GBM to eliminate unnecessary diagnostic procedures and reduce hospital costs to improve patient outcomes.
Key words: Anti-glomerular basement membrane (anti-GBM), ANCA (anti-neutrophil cytoplasmic antibodies), autoimmune, serology, laboratory testing
Int. J. Bio. Lab. Sci 2023(12)2:65-72 【PDF】
