ABSTRACT
OBJECTIVES: The American Society of Hematology's 4T scoring system is a validated tool to assess a patient's probability of having heparin-induced thrombocytopenia (HIT) before testing is performed. There is no benefit to testing patients with a low probability 4T score for HIT. This study aimed to assess for inappropriate HIT testing at our institution based on 4T scoring. METHODS: We retrospectively reviewed 201 patient charts and calculated 4T scores and testing costs to assess for inappropriate testing and the economic impact of such testing. RESULTS: HIT testing often occurred in the least appropriate patients and resulted in tens of thousands of dollars of waste for unnecessary testing. CONCLUSIONS: Inappropriate testing for HIT is still a prevalent issue despite literature supporting the 4T score for guidance in testing appropriateness.
Subject(s)
Cost-Benefit Analysis/classification , Heparin/adverse effects , Overtreatment/economics , Thrombocytopenia/etiology , Adult , Aged , Anticoagulants/adverse effects , Anticoagulants/therapeutic use , Clinical Laboratory Techniques/economics , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Cost-Benefit Analysis/methods , Female , Heparin/therapeutic use , Humans , Male , Middle Aged , Overtreatment/prevention & control , ROC Curve , Retrospective StudiesABSTRACT
We investigate the use of natural language processing (NLP) for enhancing precision when retrieving Medline citations on diagnostic procedure. Inter-annotator agreement is described as part of the evaluation method, and preliminary results are presented.
