Establishment of cohort of consecutive ANCA test requests at MU- Preliminary 3 month data review [abstract]

Abstract

Background: Anti Neutrophil Cytoplasmic Antibodies (ANCA) are used to diagnose and monitor certain primary small vessel vasculitides. The results are often nonspecific. ANCA testing guidelines and gating policies have been proposed to improve appropriate ordering and to discourage inappropriate use which often leads to erroneous diagnoses and dangerously improper immunosuppressive treatments. Methods: Database with information on all consecutive ANCA requests at MU has been established beginning June 1st 2009(the date testing began at the MU ANA lab). Patients' medical records in the first 3 months were reviewed to identify the indications for testing. Clinical data on requests for the remainder of the year will be collected. Patient charts one year from the date of request will be reviewed to see if a diagnosis of vasculitis is made. Conclusion: 75% of requests did not meet testing guidelines, deemed inappropriate. For quality improvement, data will be monitored and the information will be shared with the requesting physicians. Additional research will be performed on whether such education improves the test ordering patterns.