Optimal Utilization of Laboratory Testing
This parasitic investigation of the stool specimen was developed by Dr. Bobbi Pritt on our staff and shows several strategies. The first is if there is watery diarrhea in a patient who has AIDS or who has contact with farm animals or is involved in outbreak of municipal water supply or day care centers, then we recommend cryptosporidium antigen and if it's positive, no additional testing is required unless the clinical picture indicates otherwise.
If you go to the middle box, if there is watery diarrhea in patients who are less than or equal to 5 years old or have contact, or they are campers or backpackers, or they are involved in outbreak in resort community or day care centers, then we recommend the Giardia antigen. And again if the results are positive, no additional testing is required.
And finally, the third box shows if the patient is a resident or visitor to a developing country or a resident or visitor to an area or North America where helminth or worm infections have been reported with some frequency, then you proceed with the parasitic examination detecting either roundworms or tapeworms or if it’s positive you will detect the organism. And if diarrhea persists despite all these tests then specific exam for Microsporidia or Cyclospora are recommended. Note that if we follow this parasitic investigation of the stool specimens, we can eliminate many of the cases of ova and parasites. So like any hospital and clinic laboratories you may get a lot of ova and parasite requests. Following this algorithm and eliminate many of those.
Parasitic Investigation of Stool Specimens
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- Assumptions to Forego
- Roger's Adopter Categories Based on Degree of Innovativeness1
- Changes to Manual Requisitions2,7
- Is This Test Misused?
- Overused/Misused Tests: Good Literature Support
- Bleeding Time3
- Anti–Single–Stranded DNA: Another Misused Test4,5,6
- Use of Algorithms
- Laboratory Test Utilization
- Thyroid Testing Guidelines
- Thyroid Function Ordering Algorithm
- Pernicious Anemia Testing Guidelines
- Pernicious Anemia Testing Cascade
- Diarrhea Work Up Guidelines
- Parasitic Investigation of Stool Specimens Algorithm
- Obsolete Tests: Laboratory Directors' Opinions7
- Overused/Misused Tests — Opinion
- Frequency of Testing
- Newer Tests and Panels on the Horizon
- Hints on Improving Lab Utilization
- Hints on Improving Lab Utilization (2)
- Interventions to Improve Lab Utilization7
- Algorithm for Assessing Send–out Tests
- Improved Test Utilization: Assistance from Clinical Practice Committee
- Other Benefits of Clinical Practice Committee
- I Welcome Your Questions