Assessment of regulation on vitamin D test requesting in terms of the rational laboratory use

Abstract

Abstract Objectives The aim of this study is to identify the possible effects of the Ministry of Health regulation on Vitamin D testing and vitamin D deficiency detection and to investigate the effect of the reflex test algorithm implementation. Materials and methods A total of requested 78,919 25(OH)D and 5,653 1,25(OH)2D test results were examined. Test requests were classified in 3 groups according to the Regulation; Group 1: Requests from inpatients and intensive care units, Group 2: Requests from outpatients of non-restricted departments, Group 3: Requests from outpatients of restricted departments. In addition, the reflex test algorithm was simulated and the name of the 1,25-dihydroxyvitamin D test request was changed to 1,25-dihydroxycholecalciferol. Results Changing the test name as 1,25 dihydroxycholecalciferol reduced the number of monthly test requests (−71.7%). The hypovitaminous detection rate was similar in Group 1, 2, and 3 in the 25(OH)D requests and was higher in the reflex test algorithm. In 1,25(OH)2D requests, the rate of hypovitaminous detection was higher in Group 1 than in Group 2 and 3. Discussion With simple acts like using structured test ordering forms, reflex test algorithms applied in the clinic-laboratory-interface involving Medical Biochemistry Specialists, bigger impact with less underdiagnosis might be possible in test demand management.