{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T10:17:49Z","timestamp":1698142669497},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of this study was to determine variables predictive of abnormal comprehensive metabolic panel (CMP) results in pediatric emergency department (PED) patients and the potential cost savings of a basic metabolic panel (BMP) versus a CMP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This is a retrospective cross-sectional descriptive study of children (&lt;18 y) at an urban academic PED (annual census, 22,000). Clinical data included 12 clinical variables: right upper quadrant pain, overdose, emesis, liver disorder, malignancy, heart disease, bleeding disorder, jaundice, right upper quadrant tenderness, hepatomegaly, ascites\/peripheral edema and shock, and the liver function test (LFT) results not in a BMP (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, total protein, and albumin).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>There were 207 children in the study population. The mean age was 8 years. There were 106 boys (51%).<\/jats:p>\n            <jats:p>Variables significantly associated with abnormal LFT result were history of liver disease (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.007), history of heart disease (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.040), jaundice (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.045), and hepatomegaly (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.048). The false-negative rate was 16%. However, of the 10 patients for whom this false-negative rate remained true, the LFT values were marginally abnormal, and performance of further investigation of these results was minimal to none. There were 66 patients with no clinical variables and normal CMP results. With a cost difference of $21 between BMP and CMP, this gives a potential savings of $7125 if extrapolated for 1 year in our PED.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Limiting testing to a BMP for patients with none of the 12 clinical variables has the potential annual cost savings of $7125.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001119","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T15:12:50Z","timestamp":1493737970000},"page":"315-319","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Variables for Abnormal Comprehensive Metabolic Panel Testing and Potential Cost Savings in Children Receiving Pediatric Emergency Department Care"],"prefix":"10.1097","volume":"33","author":[{"given":"Matthew David","family":"Huckaby","sequence":"first","affiliation":[{"name":"From the *Louisiana State University Health Science Center Shreveport, Shreveport, LA; and \u2020Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shayla","family":"Freeman","sequence":"additional","affiliation":[{"name":"From the *Louisiana State University Health Science Center Shreveport, Shreveport, LA; and \u2020Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Thurmond","sequence":"additional","affiliation":[{"name":"From the *Louisiana State University Health Science Center Shreveport, Shreveport, LA; and \u2020Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Cooper","sequence":"additional","affiliation":[{"name":"From the *Louisiana State University Health Science Center Shreveport, Shreveport, LA; and \u2020Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Losek","sequence":"additional","affiliation":[{"name":"From the *Louisiana State University Health Science Center Shreveport, Shreveport, LA; and \u2020Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib4-20231023","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1001\/jama.2012.362","article-title":"Eliminating waste in US health care","volume":"307","year":"2012","journal-title":"JAMA"},{"key":"bib6-20231023","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1136\/pgmj.2006.049551","article-title":"Factors contributing to inappropriate ordering of tests in an academic medical department and the effect of an educational feedback strategy","volume":"82","year":"2006","journal-title":"Postgrad Med J"},{"key":"bib7-20231023","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1542\/peds.2012-1753","article-title":"General pediatric attending physicians' and residents' knowledge of inpatient hospital finances","volume":"131","year":"2013","journal-title":"Pediatrics"},{"key":"bib8-20231023","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1046\/j.1525-1497.2003.20115.x","article-title":"Improving physicians' knowledge of the costs of common medications and willingness to consider costs when prescribing","volume":"18","year":"2003","journal-title":"J Gen Intern Med"},{"key":"bib9-20231023","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.amjmed.2013.05.015","article-title":"Teaching high-value, cost-conscious care: improving residents' knowledge and attitudes","volume":"126","year":"2013","journal-title":"Am J Med"},{"key":"bib10-20231023","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1001\/jamainternmed.2013.232","article-title":"Impact of providing fee data on laboratory test ordering: a controlled clinical trial","volume":"173","year":"2013","journal-title":"JAMA Intern Med"},{"key":"bib11-20231023","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1001\/jama.1994.03510350037034","article-title":"Implementation of the Ottawa ankle rules","volume":"271","year":"1994","journal-title":"JAMA"},{"key":"bib12-20231023","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"bib13-20231023","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1056\/NEJMoa031375","article-title":"The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma","volume":"349","year":"2003","journal-title":"N Engl J Med"},{"key":"bib14-20231023","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/j.1553-2712.1997.tb03578.x","article-title":"Calcium, magnesium, and phosphorus: Emergency department testing yield","volume":"4","year":"1997","journal-title":"Acad Emerg Med"},{"key":"bib16-20231023","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1016\/S0140-6736(05)66422-7","article-title":"Refining clinical diagnosis with likelihood ratios","volume":"365","year":"2005","journal-title":"Lancet"},{"key":"bib17-20231023","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0196-0644(98)70352-X","article-title":"Clinical utility of likelihood ratios","volume":"31","year":"1998","journal-title":"Ann Emerg Med"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201705000-00002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T02:02:20Z","timestamp":1698026540000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201705000-00002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001119","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}