{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:30:13Z","timestamp":1768523413193,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T00:00:00Z","timestamp":1604620800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current guidelines pertaining to diagnosing macrocytic anemia in association with vitamin B12 and folate deficiency recommend that vitamin B12, folate, homocysteine, and methylmalonic acid assays should be assessed concurrently due to their close relationship in metabolism. We aimed to investigate the completion of these assays in local clinics and hospitals without in\u2010house clinical laboratories in Korea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed data from the laboratory information system between September 25, 2017, and June 30, 2019, to investigate usage rates of vitamin B12, folate, homocysteine, and methylmalonic acid assays in patients with macrocytic anemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 14\u00a0894 Korean adults among 109\u00a0524 (13.6%) total hemoglobin\u2010tested subjects underwent concurrent erythrocyte mean corpuscular volume (MCV) tests. Among these 14,894 adults, 265 (1.2%) from 94 local clinics or hospitals without in\u2010house clinical laboratories in Korea had macrocytic anemia. Furthermore, among these 265 adults, only one woman underwent serum vitamin B12 and folate assay and one man underwent serum homocysteine testing during the study period. No patients among the 265 individuals with macrocytic anemia received erythrocyte folate or methylmalonic acid testing (with either serum, plasma, random urine, or 24\u2010hour collected urine).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this study provide basic information regarding utilization rates of assays in association with vitamin B12 and folate deficiency. Making more data available is expected to improve rates of testing in patients with macrocytic anemia in local clinics and hospitals without in\u2010house clinical laboratories in Korea.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.23441","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T16:53:53Z","timestamp":1604681633000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Test utilization for the diagnosis of vitamin B12 and folate deficiency in local clinics in Korea"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8266-2248","authenticated-orcid":false,"given":"Rihwa","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"},{"name":"Department of Laboratory Medicine and Genetics Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngju","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi\u2010Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serim","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngrae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4672-5811","authenticated-orcid":false,"given":"Sang Gon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2517-175X","authenticated-orcid":false,"given":"Eun Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Green Cross Laboratories Yongin Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2018-205048"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19438"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1113996"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12959"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-569186"},{"key":"e_1_2_9_7_1","volume-title":"Developing and Managing a Medical Laboratory (Test) Utilization Management Program","author":"CLSI","year":"2017"},{"issue":"1","key":"e_1_2_9_8_1","first-page":"15","article-title":"Towards better test utilization \u2010 strategies to improve physician ordering and their impact on patient outcomes","volume":"26","author":"Freedman DB","year":"2015","journal-title":"Ejifcc"},{"key":"e_1_2_9_9_1","unstructured":"Test Utilization Committee Korean Society for Laboratory Medicine.Laboratory Tests Utilization Management guideline.2020."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqx147"}],"container-title":["Journal of Clinical Laboratory 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