Long-term impact of a restrictive laboratory test ordering form on tumor marker prescriptions
Long-term impact of a restrictive laboratory test ordering form on tumor marker prescriptions
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DOI：
10.1017/s0266462303000102
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发表时间：
2003-12-01
影响因子：
3.2
通讯作者：
Chaussade, S
中科院分区：
文献类型：
--
作者：
Durieux, P;Ravaud, P;Chaussade, S
目的：评估一项旨在减少胃肠疾病常用的三种肿瘤标志物（癌胚抗原、甲胎蛋白、碳水化合物抗原19-9）排序的干预措施的长期影响。方法：采用时间序列分析对某教学医院进行前瞻性研究。制定了当地的临床指导方针，并通过一种新的订购表格加以实施，旨在提醒医生，限制实验室测试的订购。在全院进行干预前后的3个月内，记录订购标记物的数量与入院人数的比例；在医院的两个病房（消化内科和内科）进行干预后的4年期间，每月记录一次。为了评估肿瘤标志物订单的适当性，在实施新订单之前和之后（1个月和2年后）对订单样本进行审计。结果：协方差分析显示，医院干预的效果显著(p
Objective: To evaluate the long-term impact of an intervention designed to reduce the ordering of three tumor markers frequently prescribed for gastroenterologic diseases (carcinoembryonic antigen, alpha-fetoprotein, carbohydrate antigen 19-9).Methods: A prospective study with time series analysis in a teaching hospital. Local clinical guidelines were developed and implemented through a new order form, designed as a reminder to the physician, restricting the ordering of laboratory tests. Ratios between the number of markers ordered and number of admissions were recorded during a 3-month period before and after intervention in the whole hospital and monthly on a 4-year period in two wards of the hospital (Department of Gastroenterology and Department of Internal Medicine). To evaluate the appropriateness of tumor marker orders, audits were performed on a sample of order forms, before and after (1 month and 2 years after) the implementation of the new order form.Results: The analysis of covariance showed a significant effect of the intervention in the hospital (p