Does Provider Specialty Matter?

Author:

Stubblefield Jeannie M1ORCID,Lasley Mary V2345,Virant Frank S2345,Dickerson Jane A16

Affiliation:

1. Department of Laboratory Medicine, University of Washington, Seattle

2. Department of Pediatrics, University of Washington, Seattle

3. Northwest Asthma & Allergy, Seattle, WA

4. Seattle Allergy & Asthma Research Institute, Seattle, WA

5. Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA

6. Department of Laboratories, Seattle Children’s Hospital, Seattle, WA

Abstract

Abstract Objectives Multiple practice guidelines discourage indiscriminate use of broad panels of allergen-specific IgE (sIgE) tests due to increased risk of false positives and misinterpretation of results. We provide an analytical framework to identify specialty-specific differences in ordering patterns and effectiveness, which can be used to improve test utilization. Methods Test results from a tertiary pediatric hospital were analyzed by ordering specialty to evaluate size of allergen workups. Positivity rates were analyzed to determine effectiveness in selecting tests with high positive pretest probabilities. Laboratory test menu components were also evaluated. Results Our findings demonstrate 29% of sIgE tests are ordered as part of broad workups (>20 sIgE tests/date of service) contrary to the recommended testing approach. Detailed descriptions of ordering patterns and positivity rates are provided. Conclusions This study provides a framework for using a cross-sectional analytical approach to assess test utilization patterns and evaluate components of laboratory testing menus.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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