Premium
An Italian Multicenter Study for Application of a Diagnostic Algorithm in Autoantibody Testing
Author(s) -
Bonaguri Chiara,
Melegari Alessandra,
Dall’Aglio PierPaolo,
Ballabio Andrea,
Terenziani Paolo,
Russo Annalisa,
Battistelli Luisita,
Aloe Rosalia,
Camisa Roberta,
Campaniello Giovanna,
Sartori Elisabetta,
Monica Cesare
Publication year - 2009
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.04635.x
Subject(s) - autoantibody , guideline , medicine , anti nuclear antibody , test (biology) , disease , diagnostic test , autoimmune disease , algorithm , pediatrics , immunology , antibody , pathology , paleontology , biology , computer science
The presence in the serum of specific autoantibodies, such as antinuclear antibodies (ANA), anti‐double‐stranded DNA (anti‐dsDNA), and antiextractable nuclear antigens (anti‐ENA), is one of the diagnostic criteria for autoimmune rheumatic disease, and the requests for these tests in the last few years have grown remarkably. A guideline for reducing clinically inappropriate requests in autoantibody testing (ANA, anti‐dsDNA, anti‐ENA) has been applied in the Parma Hospital since 2007. The results for the period January–December 2007 were compared to those of the previous period January–December 2006, and a significant reduction in the number of anti‐dsDNA (23.9%) and anti‐ENA (20.7%) was found. The aim of this study was to assess the applicability of a similar guideline in a wide area (Parma, Modena, Piacenza, Reggio‐Emilia) with reference to the diagnosis of autoimmune rheumatic disease. This project, supported by a regional grant for innovative research projects, was started in January 2008 and consists of three different steps: (1) a study group of clinicians and laboratory physicians to evaluate the diagnostic criteria, the analytical procedures, and the number of tests performed in different hospitals; (2) developing common guidelines for autoantibody testing that takes into account the different clinical needs with the aim of improving efficiency and clinical effectiveness of diagnosis and monitoring; and (3) assessing compliance with the guidelines in the different hospitals that are evaluating the second‐level test (anti‐dsDNA, anti‐ENA) decrease. We think that the validation of guidelines for the laboratory diagnosis of autoimmune rheumatic disease can represent a tool for improving patients’ outcomes and economic efficiency.