Gereksiz serbest PSA test istemleri ve önleyici faaliyetlerin etkinliğinin değerlendirilmesi

OpenAlex Turkish

Objective: The aim of our work is to determine unnecessary fPSA test requests according to the European Association of Urology, European Society for Radiotherapy & Oncology guideline (EAPS-ESTRO-SIOG) and to assess the effectiveness of preventive actions we have made due to unnecessary test order. Methods: According to the guidelines of EAPS-ESTRO-SIOG, the use of fPSA/tPSA ratio is considered clinically insignificant in patients with tPSA >10ng/mL or <4ng/mL. Measurement uncertainty for tPSA was calculated as±15.49% in our laboratory. The limit values(4 and 10 ng/mL)were expanded according to the uncertainty value. fPSA tests ordered in patients with tPSA levels <3.38 and >11.54 ng/mL were considered unnecessary. In addition, if the patient did not have a tPSA test previously performed in another laboratory, the requested fPSA tests in patients without tPSA test in our laboratory was evaluated as unnecessary. An informational message has been added to the hospital information system regarding the guideline recommendation for the fPSA. Unnecessary fPSA tests in the six-month term before and after adding the information note were evaluated. Results: The number of unnecessary fPSA test significantly decreased in the six-month term after the addition of information note(p<0.05). The fPSA test was not requested without the tPSA test in 6 month period after the addition of the information note. Conclusion: It is important to use the rules and algorithms mentioned in the guidelines when ordering the test. The results of our study suggest that the addition of an informative message according to the guideline recommendation to the hospital information system can reduce the unnecessary test order.