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. 2016 Dec;55(14):1279-1288.
doi: 10.1177/0009922815624902. Epub 2016 Jul 19.

Use of Rheumatology Laboratory Studies Among Primary Pediatricians

Colleen K Correll  1 , Logan G Spector  1 , Lei Zhang  1 , Bryce A Binstadt  1 , Richard K Vehe  1
Affiliations

Use of Rheumatology Laboratory Studies Among Primary Pediatricians

Colleen K Correll et al. Clin Pediatr (Phila). 2016 Dec.

Abstract

Rheumatology laboratory tests are often inappropriately ordered in situations for which they are of low diagnostic utility. We surveyed pediatricians to investigate reasons for ordering these tests. The response rate was 15.3% (93/609). The most commonly ordered tests were antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA) antibody, and rheumatoid factor (RF). Of the 89% (83/93) who ordered an ANA, 86% ordered it for correct/possibly correct reasons; of the 73% (68/93) who ordered RF, 80% did so for correct/possibly correct reasons; and among the 59% (54/92) who had ordered anti-dsDNA antibody, 34% ordered it for correct reasons. A positive relationship was seen between years since residency completion and correct use of ANA. However, positive associations were not seen between measures of pediatric rheumatology experience and correct use of other tests. Interventions are needed to improve pediatricians' utilization of rheumatology tests.

Keywords: HLA-B27; antinuclear antibody; cyclic citrullinated peptide; double-stranded DNA; laboratory test; pediatric rheumatology; pediatrician; primary care; referral; rheumatoid factor.

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Conflict of interest statement

Conflicts of Interest: The authors report no conflicts of interest regarding this research. The authors report no financial support or financial interest regarding this research.

Figures

Figure 1
Figure 1
Primary pediatrician study population
Figure 2
Figure 2
Self-reported reasons for ordering a rheumatology lab test
Figure 3
Figure 3
Reasons indicated for referring to PR.*
See this image and copyright information in PMC

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