gms | German Medical Science

Interdisciplinarity is a main feature of high quality diagnostics, therapy, and management of patients with inflammatory/ rheumatological diseases. Normally, the patient is seen both in a rheumatological and ophthalmological clinic. These separate examinations are inconvenient for the patients because of frequent appointments and the distances between clinics. Loss of information may cause inadequate decision making concerning therapy or inefficient planning of further diagnostics. The classic approach of examining patients with intraocular inflammation often consists of an expensive battery of all available diagnostic procedures.

Existing standards of uveitis diagnostic tools were screened. As an optimal strategy for an interdisciplinary center a diagnostic procedure based on clinical findings was identified with intensive interaction between ophthalmologists and rheumatologists [1]. Only when examination does not reveal a clear association with a rheumatological or ophthalmological disease, a standard test scheme depending on anatomical features of the uveitis (uveitis anterior, intermedia, posterior, or panuveitis) is implemented. We implemented this new diagnostic standard on a fixed time point (intervention), replacing the old standard diagnostic regime and compared the laboratory costs.

With our strategy we were able to get a 65% reduction in the cost of laboratory diagnostics in patients with intraocular inflammation without an increase in the number of cases of primary uveitis, which shows that the quality of our investigation did not decrease.

An efficient use of laboratory examinations in uveitis patients based on clinical findings allows a significant reduction of their costs in an interdisciplinary team.