gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Laboratory Testing by the General Practitioner

Meeting Abstract

  • M. Avonts - Domus Medica, Antwerp, Belgium; University of Antwerp, Antwerp, Belgium
  • H. Cloetens - Domus Medica, Antwerp, Belgium
  • C. Leyns - Ghent University, Ghent, Belgium
  • A. Demulder - Brugmann Hospital, Brussels, Belgium
  • P. Van Royen - Domus Medica, Antwerp, Belgium; University of Antwerp, Antwerp, Belgium
  • J. Michels - Domus Medica, Antwerp, Belgium
  • H. Philips - Domus Medica, Antwerp, Belgium; University of Antwerp, Antwerp, Belgium

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP049

DOI: 10.3205/12gin161, URN: urn:nbn:de:0183-12gin1615

Published: July 10, 2012

© 2012 Avonts et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

According to a prospective study (2007), general practitioners (GPs) do not always use scientific arguments when they request laboratory tests. The more tests performed, the more false-positive findings will be acquired, which can lead to unnecessary anxiety for the patient. So guidelines about laboratory tests in general practice are highly needed. This guideline aims to guide GPs how to request rationally laboratory tests about ten topics. We used different methods to compile this guideline. 6 Topics (cardiovascular disease, diabetes, obesity, pregnancy/preconception, fatigue, oral anticoagulation use) were extracted out of existing Belgian guidelines. For the other 4 topics (liver disease, thyroid disease, chronic renal failure, sexual transmitted disease) we used the ADAPTE procedure. The authors defined health questions from their own experience as a general practitioner. Several guideline databases were used to search for guidelines. After selecting on relevance, the AGREE instrument was used to score the methodology. We assessed the consistency of the guideline and also the acceptability and applicability in the target context. We used the GRADE approach to evaluate quality of evidence and the strength of recommendations. External experts as well as the target users reviewed the full guideline. Finally the guideline was submitted to CEBAM (Centre of Evidence Based Medicine) for validation. To implement the guideline we developed a problem oriented laboratory request form and a patient leaflet. There was a gap in guidelines on laboratory testing for general practitioners. Using different methods and with the cooperation of GPs and clinical biologists we developed a guideline filling this gap.