{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T12:13:51Z","timestamp":1752668031075},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>At Texas Children\u2019s Hospital in Houston, numerous celiac tests are ordered from a wide range of nonspecialty healthcare providers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To retrospectively examine the ordering of celiac tests before and after a test ordering initiative at our institution, to determine whether the initiative impacted appropriate usage of those tests and affected costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We carefully scrutinized all orders for comprehensive celiac testing from July 2016 through September 2017, implemented an in-house celiac-disease screening cascade, and reflexed it to the comprehensive celiac testing panel if an abnormal screening result was obtained.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 60 celiac test orders were issued during the 14-month study period. The ordering physician was a gastroenterologist in 6 cases and a nongastroenterologist in 54 cases. Of the 60 orders, only 4 were approved for sending out for comprehensive celiac testing; in 52 of the 60 cases, the order was altered to celiac screening. In the remaining 4 cases, the tests were canceled as a result of incorrect orders. Only 1 of the 52 celiac screenings yielded a positive result and thus was reflexed to the comprehensive panel.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We were able to induce appropriate celiac test usage by implementing a celiac-reflexive cascade. Also, our strategy proved to be extremely cost effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/labmed\/lmz037","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T19:13:02Z","timestamp":1555614782000},"page":"99-104","source":"Crossref","is-referenced-by-count":4,"title":["Utilization of Laboratory Testing Algorithms for Celiac Disease in a Pediatric Hospital"],"prefix":"10.1093","volume":"51","author":[{"given":"Mahesheema","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Pathology, SUNY Upstate Medical University, Syracuse, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek J","family":"Danner","sequence":"additional","affiliation":[{"name":"Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas S","family":"Fishman","sequence":"additional","affiliation":[{"name":"Division of Clinical Chemistry, Department of Pathology and Immunology, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sridevi","family":"Devaraj","sequence":"additional","affiliation":[{"name":"Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas"},{"name":"Division of Clinical Chemistry, Department of Pathology and Immunology, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"2020010600375661100_CIT0001","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12911-015-0137-7","article-title":"Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center","volume":"15","author":"Krasowski","year":"2015","journal-title":"BMC Med Inform Decis 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