Inappropriate use of commercial Antinuclear Antibody Testing in a community-based US hospital: a retrospective study

• Main Authors: Abdul S. Mohammed, Prajwal Boddu, David Mael, Mohammed Samee, Dana Villines
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2016-09-01
• Series: Journal of Community Hospital Internal Medicine Perspectives
• Subjects: antinuclear antibody; comprehensive antinuclear antibody panel; rheumatology; order sets
• Online Access: http://www.jchimp.net/index.php/jchimp/article/view/32031/pdf_199

Healthcare providers use antinuclear antibodies (ANAs) to screen and diagnose patients with autoimmune diseases. In the recent years, commercial multiplex ANA kits have emerged as a convenient and fast diagnostic method. Diagnostic testing should follow sequenced algorithms: initial screen followed by specific antibody analysis. Second-level testing as an initial screen for autoimmune disease is inappropriate. We reviewed 68 patients with ANA comprehensive panels over a 6-month period from May 2015 to October 2015. We assessed appropriateness and estimated incurred losses from inappropriate testing. We found 92.6% (63 out of 68) of the ANA comprehensive panel results to be negative. Incurred losses from inappropriate ANA comprehensive panel testing were $66,000. Physicians should become familiar with ANA-sequenced diagnostic algorithms to avoid unnecessary higher level testing.