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Vitamin B12 and folate tests : The ongoing need to determine appropriate use and public funding
Willis, Cameron D. Metz, Michael P. Hiller, Janet E. Elshaug, Adam G.
Willis, Cameron D.
Metz, Michael P.
Hiller, Janet E.
Elshaug, Adam G.
Abstract
[Extract] It's not as simple as new for old: we need to follow a process for “disinvestment” in existing medical procedures, services and technologies
Criteria have been developed for assessing the safety, effectiveness and cost‐effectiveness of new and emerging health interventions, but additional challenges exist in identifying opportunities for reducing the use of existing health technologies or procedures that are potentially overused, (cost‐)ineffective or unsafe.1 Criteria have been proposed to flag technologies that might warrant further investigation under quality improvement programs.1 These criteria are: new evidence becomes available; there is geographical variation in use; variation in care between providers is present; the technology has evolved and differs markedly from the original; there exists a temporal trend in the volume of use; public interest or controversy is present; consultation with health care workers and funders raises concerns; new technology has displaced old technology; there is evidence of leakage (use beyond the restriction or indication); the technology or intervention is a “legacy item” that has never been assessed for cost‐effectiveness; use is not in accordance with clinical guidelines; or the technology is nominated by clinical groups.
After such a nomination was made by members of the clinical laboratory community regarding vitamin B12 and folate tests, we sought to determine whether these tests met other criteria. We hope that this article will encourage debate and discussion about the appropriate use of these tests.
Keywords
health services administration, anatomy and physiology, general medicine, hematologic diseases, diagnostic techniques and procedures
Date
2013
Type
Journal article
Journal
Medical Journal of Australia
Book
Volume
198
Issue
11
Page Range
586-588
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Controlled
Open
Open