| Prospective evaluation of a clinical guideline for the diagnosis and management of iron deficiency anemia. | |
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MedLine Citation:
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PMID: 12361813 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We examined the effect of introducing an evidence-based clinical guideline on the diagnosis and evaluation of iron deficiency anemia. SUBJECTS AND METHODS: The guideline recommended measurement of serum ferritin levels for all anemic patients with a mean corpuscular volume (MCV) </=95 fL and endoscopic evaluation for those with a serum ferritin level less than 45 ng/mL. Physicians practicing in the general medicine inpatient and outpatient services of two university-affiliated hospitals were informed about the guideline and the data supporting it. Clinical evaluations during the 9 months before ("control period," n = 3341 patients) and the 9 months after ("intervention period," n = 3173 patients) the introduction of the guideline were compared. RESULTS: There was a 30% increase (95% confidence interval [CI]: 22% to 39%) in the proportion of anemic patients who underwent serum ferritin evaluation in the intervention period (41% [n = 1284]) compared with in the control period (31% [n = 1040]), and a 24% increase (95% CI: 4% to 48%) in the proportion with a serum ferritin level <45 ng/mL (8.1% [n = 256] vs. 6.5% [n = 217]). The proportion of anemic patients who underwent endoscopic evaluation within 4 months of measurement of low serum ferritin level in the intervention period (3.3% [n = 106]) was 67% higher (95% CI: 23% to 125%) than in the control period (2.0% [n = 67]), and the proportion with serious gastrointestinal lesions found as a result of endoscopy was 62% (95% CI: 8% to 145%) higher (1.8% [n = 57] vs. 1.1% [n = 37]). CONCLUSIONS: Introduction of a guideline describing appropriate evaluation of iron deficiency anemia led to an increase in the proportions of patients evaluated for iron deficiency anemia and found to have serious gastrointestinal lesions. |
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Authors:
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George N Ioannou; Jeremy Spector; Kevin Scott; Don C Rockey |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: The American journal of medicine Volume: 113 ISSN: 0002-9343 ISO Abbreviation: Am. J. Med. Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-10-03 Completed Date: 2002-10-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 281-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Gastroenterology, University of Washington and Health Services Research and Development, Puget Sound Veterans Affairs Health Care System, Seattle, Washington, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Distribution Aged Anemia, Iron-Deficiency / complications, diagnosis*, epidemiology Endoscopy, Gastrointestinal / utilization Evidence-Based Medicine Female Ferritins / blood* Gastrointestinal Neoplasms / complications, diagnosis*, epidemiology Guideline Adherence Hospitals, Teaching Humans Male Middle Aged North Carolina / epidemiology Odds Ratio Outcome Assessment (Health Care)* Practice Guidelines as Topic / standards* Prospective Studies Risk Factors |
| Chemical | |
Reg. No./Substance:
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9007-73-2/Ferritins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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