Use of tumour markers in an internal medicine department – a baseline and a post interventional study
Keywords:
tumour markers, “self-audit”, formative/informative activitiesAbstract
Background: Tumour markers (TM) are potentially useful in clinical
practice, but have a limited role in terms of diagnostic because of
their poor sensitivity and specificity. Several guidelines exist on the
appropriate use of TM, however they are frequently overused. The
aim of the present study was to assess the impact of informative
and audit activities about the correct use of TM on the use of TM
in an internal medicine department in a baseline and in a post interventional evaluation.
Results: At baseline TM were requested in 19,6% of patients
whereas after the intervention this figure dropped 42,6% to
10,2%. In the baseline study the main reason for TM request was
diagnosis while in the post-interventional study it screening. In
both studies the majority of appropriate requests were done for
screening. In both studies most of inappropriate requests were
done for diagnosis. In the baseline study 17, 5% of the requests
were considered appropriate and there were an increase of appropriateness (TM appropriated in the post-interventional study:
46%). There was an important decrease in the total costs related
to TM, mainly due to a decrease in the costs of inappropriate requests.
Discussion: The present study shows that informative and “self-audit “activities can have a positive impact in the clinical
practice, with a decreased in costs.
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