The effectiveness of an automated algorithm as a tool for investigating the cause of anaemia in undiagnosed patients from general practitioners.

IF 2.1 4区医学 Q3 MEDICAL LABORATORY TECHNOLOGY Annals of Clinical Biochemistry Pub Date : 2023-07-01 DOI:10.1177/00045632231160663

Anne Margreet de Jong, Sam Veldhuis, Firmin Candido, Wendy Pj den Elzen, Bauke A de Boer

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Abstract

Background: The Dutch guideline algorithm for the analysis of anaemia in patients of general practitioners (GPs) was programmed in a Clinical Decision Support system (CDS-anaemia) to support the process of diagnosing the cause of anaemia in the laboratory. This study investigates the diagnostic yield of the automated anaemia algorithm compared to that of the manual work up by the GP.

Methods: This retrospective population-based study consisted of 2697 people ≥18 years. Anaemia was defined according to the Dutch College of General Practitioners (DCGP) guideline. Causes of anaemia were based on the DCGP guidelines with the corresponding blood tests. The number of blood tests and causes of anaemia were measured in two separate periods in both the (CDS-anaemia) pilot group and a control group in which routine care was provided.

Results: Patients from GPs supported by CDS-anaemia had higher chances of having more anaemia-related blood tests being performed. This resulted in finding significantly more causes of anaemia in the pilot group compared to the control group with respect to iron deficiency (resp. 31.3% vs 14.5%), possible iron deficiency (resp. 11.4% vs 2.8%), iron deficiency in acute phase (2.6% vs 0.5%), chronic disease/infection/inflammation (23.5% vs 1.9%), vitamin B12 deficiency (4.5% vs 1.9%), possible vitamin B12 deficiency (16.8% vs 8.7%), folate deficiency (3.3% vs 0.9%) and possible bone marrow disorder (3.8% vs 0.0%); p < 0.05.

Conclusions: This study suggests that an automated-algorithm support can effectively aid in the diagnostic work-up of anaemia in primary care to find more causes of anaemia.

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自动算法的有效性，作为一种工具，调查贫血的原因，从全科医生未确诊的患者。

背景:在临床决策支持系统(cds -贫血)中编写了全科医生(GPs)贫血患者分析的荷兰指南算法，以支持实验室诊断贫血原因的过程。本研究调查的诊断产量的自动贫血算法相比，手工工作的GP。方法:这项基于人群的回顾性研究包括2697名年龄≥18岁的患者。贫血是根据荷兰全科医师学院(DCGP)指南定义的。贫血的原因是基于DCGP指南和相应的血液检查。在(cds -贫血)试验组和提供常规护理的对照组中，在两个不同的时期测量了血液检查的次数和贫血的原因。结果:由cds贫血支持的全科医生的患者有更高的机会进行更多的贫血相关血液检查。结果发现，与对照组相比，试验组在缺铁方面明显有更多的贫血原因。31.3% vs 14.5%)，可能缺铁。急性期缺铁(2.6% vs 0.5%)、慢性疾病/感染/炎症(23.5% vs 1.9%)、维生素B12缺乏(4.5% vs 1.9%)、可能的维生素B12缺乏(16.8% vs 8.7%)、叶酸缺乏(3.3% vs 0.9%)和可能的骨髓疾病(3.8% vs 0.0%);P < 0.05。结论:本研究提示，自动化算法支持可以有效地帮助初级保健的贫血诊断工作，以发现更多的贫血原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical Biochemistry Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

5.20

自引率

4.50%

发文量

期刊介绍： Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine. Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals. Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).