Evidence map›Paper›PMID 31331450›Full record

ArticleThe American journal of the medical sciences2019

When Do Clinicians Follow-up Abnormal Liver Tests in Primary Care?

Andrew D Schreiner, John Bian, Jingwen Zhang, Elizabeth B Kirkland, Marc E Heincelman, Samuel O Schumann, Patrick D Mauldin, William P Moran, Don C Rockey

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Article in The American journal of the medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Andrew D SchreinerDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina. Electronic address: schrein@musc.edu.
John BianDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Jingwen ZhangDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Elizabeth B KirklandDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Marc E HeincelmanDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Samuel O SchumannDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Patrick D MauldinDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
William P MoranDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Don C RockeyDepartment of Medicine, Medical University of South Carolina, Charleston, South Carolina.

Funding

Improving the Diagnosis of Liver Disease in Primary Care Patients with Abnormal Liver FunctionK23DK118200 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI SCHREINER, ANDREW DAVID · 2018 to 2022
$866k
NIDDK NIH HHS K23 DK118200
6 · The paper itself

Abstract

backgroundMany guidelines addressing the approach to abnormal liver chemistries, including bilirubin, transaminases and alkaline phosphatase, recommend repeating the tests. However, when clinicians repeat testing is unknown. MATERIAL AND

methodsThis retrospective study followed adult patients with abnormal liver chemistries in a patient-centered medical home (PCMH) from 2007 to 2016. All PCMH patients possessing at least 1 abnormal liver test (total bilirubin, aminotransferases and alkaline phosphatase) were included. Patients were followed from the index abnormal liver chemistry until the next liver test result, or the end of the study period. The primary predictor variable of interest was the number of abnormal chemistries (out of 4) on index testing. Demographic and clinical variables served as other potential predictors of outcome. A Cox proportional hazards model was applied to investigate associations between the predictor variables and the time to repeat liver chemistry testing.

resultsOf 9,545 patients with at least 2 PCMH visits and 1 liver test abnormality, 6,489 (68%) obtained repeat testing within 1 year, and 80% of patients had follow-up tests within 2 years. Patients with multiple abnormal liver tests and those with higher degrees of abnormality were associated with shorter time to repeat testing.

conclusionsA large proportion of patients with abnormal liver tests still lack repeat testing at 1 year. The number of liver abnormal liver tests and degree of elevation were inversely associated with the time to repeat testing.

Indexed as

LiverElectronic Health RecordsFemaleFollow-Up StudiesHumansLiver DiseasesLiver Function TestsMaleMiddle AgedPhysicians, Primary CarePredictive Value of TestsPrimary Health CareProportional Hazards ModelsRetrospective StudiesSouth CarolinaTime FactorsDiagnosisElectronic health recordLiver diseaseLiver function testsQuality

Identifiers

PMID31331450
PMCPMC6658090

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.