Tracing a roadmap for vitamin B12 testing using the health technology assessment approach
Recensione
Data di Pubblicazione:
2014
Citazione:
Tracing a roadmap for vitamin B12 testing using the health technology assessment approach [Recensione] / S. Ferraro, R. Mozzi, M. Panteghini. - In: CLINICAL CHEMISTRY AND LABORATORY MEDICINE. - ISSN 1434-6621. - 52:6(2014), pp. 767-777. [10.1515/cclm-2013-0738]
Abstract:
Abstract: In our hospital, we are currently working to manage the appropriateness of vitamin B12 (B12) testing. Unfortunately, the classic evidence-based approach is unhelpful
in this process and meta-analyzing data on the accuracy of this marker for cobalamin deficiency detection is mis-
leading due to the lack of reference diagnostic methods.
The approach currently proposed by the Health Technology Assessment (HTA) enables us to tackle the issue of
B12 requests as a “healthcare” problem by considering the position of stakeholders involved in ordering, performing, interpreting the test, and receiving its results. Clinical
expectations, methodological issues, and ethical aspects concerning the performance of the test can aid us in providing more guidance on the use of this marker. By building such structured information, hemodialysis patients and pregnant women have emerged as those groups preferentially requiring B12 testing, as it may potentially improve the clinical outcome. To avoid misinterpretation
of B12 results more care should be taken in considering its biochemical and biological features, as well as the analytical issues. Spurious values obtained by current automated
immunoassays may reflect suboptimal pre-analytical steps as well as known interfering conditions. Furthermore, the harmonization of results by available methods is still a farreaching goal and the approach to interpret an individual’s results should be improved. Tracing a roadmap for B12 testing by exploiting the HTA model to balance the stake-holders’ claims and maximizing the patient’s outcome may help to manage the marker demand.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Biological variability; Biomarker; Cut-off; Diagnosis; Traceability
Elenco autori:
S. Ferraro, R. Mozzi, M. Panteghini
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