Unnecessary serum protein electrophoresis test requests in the follow-up of multiple myeloma patients can be prevented
Özgür Aydın1, Volkan Karakuş2, Merve Dinçer1, Güzin Aykal1, Hamit Yasar Ellidag11Biochemistry Laboratory, Antalya Training and Research Hospital, Antalya, Türkiye2Department of Hematology, Antalya Training and Research Hospital, Antalya, Türkiye
INTRODUCTION: Appropriate testing is a part of good laboratory practices. “Requesting the right test with the right method, at the right time, to the right patient, to produce the right result at the right cost” has been defined as an appropriate test request. This study was intended to measure the impact of an attend to regulate requests for serum protein electrophoresis tests before and after applying rejection rules and clinical management.
METHODS: In a meeting in December 2022, hematologists declared to be more careful about proper testing in electrophoresis. In addition, the laboratory was decided to be involved in test request management through test rejection rules. Multiple myeloma patients with measurable M protein spikes in the gamma regions of serum protein electrophoresis tests were chosen due to relatively well-defined follow-up protocols. Number of hospital visits of the patients and electrophoresis test requests were compared with the year before (2022) and the year after (2023) the meeting.
RESULTS: Selected 92 patients visited our hospital 493 times in 2022 and 583 times in 2023 (number of visits). A total of 423 serum protein electrophoresis (SPE) and 416 serum immunofixation electrophoresis (SIFE) tests were requested in 2022 while 427 SPE and 470 SIFE tests were requested in 2023. In 2023, 51 SPE and 36 SIFE test requests were rejected according to the defined test rejection rules.
DISCUSSION AND CONCLUSION: From 2022 to 2023 total patient visits increased by 18%, while SPE test requests increased by less than 1% and SIFE test requests increased by 13%. The common will by the Hematology Clinic and the Clinical Biochemistry Laboratory to reduce unnecessary electrophoresis test requests achieved their goal as the rise in test requests were under the rise in hospital visits. After a year of experience, we could confidently propose that our test rejection rules can be adopted by laboratories and used for electrophoresis test management.
Manuscript Language: English