Rheumatic Diseases
Conditions
Keywords
Antinuclear antibody (ANA), Overuse, Rheumatologists, Quality of care
Brief summary
The aim of this study is to assess the effect of a simple intervention (a combination of education and feedback) on Antinuclear Antibody (ANA) testing. This aim was chosen because of the known overuse of many laboratory tests, of which ANA testing is one. As overuse of ANA tests can have negative consequences (both for patients and society), the investigators designed an intervention to see how this would influence Antinuclear Antibody testing by rheumatologists.
Interventions
BEHAVIORALEducation and feedback
Sponsors
Sint Maartenskliniek
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
rheumatologists: * rheumatologists who are consulting patients at the rheumatology outpatient clinic of a participating centre
Exclusion criteria
rheumatologists: * rheumatologists not working the full study period (pre- and post-intervention) at a participating centre * rheumatologists not giving their consent to participate Inclusion Criteria patients - all patients with an ANA test requested by an included rheumatologist during the study period
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline (pre-intervention) ANA/new patient ratio (APR) at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Number of ANA tests divided by the number of new patients |
| Change from baseline (pre-intervention) % of positive ANA tests at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Percentage of ANA tests reported as positive by the local laboratory. ANA tests reported as 'weakly positive' are regarded as negative. |
| Change from baseline (pre-intervention) % of repeated ANA testing at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Percentage of patients with ≥1 ANA test in 12 months (pre- or post-intervention period) |
| Change from baseline (pre-intervention) % of ANA associated diagnoses at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Percentage of patients, in which an ANA is done during the study period, with final diagnosis of SLE, SSc, PM/DM, MCTD or SS |
| Change from baseline (pre-intervention) APR variation between rheumatologists at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Standard deviation around the mean APR, calculated from the APRs of the individual rheumatologists |
| Change from baseline (pre-intervention) reaching the of target APR at 12 months (post-intervention) | Pre- and post-intervention (both 12 months) | Difference (percentage) between the actual APR and the target-APR defined during the intervention |
Countries
Netherlands
Outcome results
None listed