Peter L Perrotta1, Ryan Jones, Rhona J Souers, Teresa P Darcy, Peter J Howanitz. 1. From the Department of Pathology, West Virginia University, Morgantown (Dr Perrotta and Mr Jones); the Biostatistics Department, College of American Pathologists, Northfield, Illinois (Ms Souers); the Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison (Dr Darcy); and the Department of Pathology, SUNY Downstate, Brooklyn, New York (Dr Howanitz).
Abstract
CONTEXT: Ensuring laboratory tests are performed at intervals consistent with established, evidence-based guidelines in diabetic patients is an important aspect of laboratory utilization. OBJECTIVES: To measure how frequently diabetes mellitus patients are tested for hemoglobin A1c (HbA1c), low-density lipoprotein, and urine protein and to determine whether the frequencies with which these analytes are tested are consistent with recognized guidelines. DESIGN: Participants prospectively identified up to 40 patients with a current HbA1c result and at least 2 previous measurements within the past 24 months. For each patient identified with at least 3 HbA1c measurements during a 24-month period, participants also determined the number of low-density lipoprotein and spot or random urine protein tests that were performed during those 24 months. RESULTS: Participants from 49 institutions submitted a total of 1915 cases that met the study criteria of at least 3 HbA1c test results within the past 24 months. Approximately 95% of patients had 8 or fewer HbA1c tests in the past 24 months; 79% of patients with at least 3 HbA1c tests had at least 2 low-density lipoprotein tests and 27% had at least 2 urine protein tests reported during the 24-month study period. CONCLUSION: Participating laboratories were generally successful in documenting appropriate utilization of HbA1c testing in diabetes mellitus monitoring, but had more difficulty documenting that diabetes mellitus patients had annual testing for low-density lipoprotein and urine protein.
CONTEXT: Ensuring laboratory tests are performed at intervals consistent with established, evidence-based guidelines in diabeticpatients is an important aspect of laboratory utilization. OBJECTIVES: To measure how frequently diabetes mellituspatients are tested for hemoglobin A1c (HbA1c), low-density lipoprotein, and urine protein and to determine whether the frequencies with which these analytes are tested are consistent with recognized guidelines. DESIGN:Participants prospectively identified up to 40 patients with a current HbA1c result and at least 2 previous measurements within the past 24 months. For each patient identified with at least 3 HbA1c measurements during a 24-month period, participants also determined the number of low-density lipoprotein and spot or random urine protein tests that were performed during those 24 months. RESULTS:Participants from 49 institutions submitted a total of 1915 cases that met the study criteria of at least 3 HbA1c test results within the past 24 months. Approximately 95% of patients had 8 or fewer HbA1c tests in the past 24 months; 79% of patients with at least 3 HbA1c tests had at least 2 low-density lipoprotein tests and 27% had at least 2 urine protein tests reported during the 24-month study period. CONCLUSION: Participating laboratories were generally successful in documenting appropriate utilization of HbA1c testing in diabetes mellitus monitoring, but had more difficulty documenting that diabetes mellituspatients had annual testing for low-density lipoprotein and urine protein.