{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:28:33Z","timestamp":1781688513495,"version":"3.54.5"},"reference-count":22,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"<jats:p>An appropriate management of anaemia laboratory tests is crucial for a correct diagnosis and treatment. A non-sequential \u201cshotgun\u201d approach (where every anaemia related test is ordered) causes workload and cost increases and could be potentially harmful. We have implemented a Decision Support System through our laboratory information system (LIMS) based on reflexive algorithms and automatic generation of interpretative reports specifically in diagnosis of anaemia for primary care patients.\nWhen a request contained an \u201cAnaemia Suspicion Study\u201d profile, more than twenty automatic reflexive rules were activated in our LIMS based upon laboratory results. These rules normally involved the addition of reflexive tests. A final report was automatically generated for each interpretation which was always reviewed for their validity by two staff pathologists. We measured the impact of this system in the ordering of most common anaemia related tests and if a proper treatment was established based on the interpretive report.\nFrom all the studies performed, only 12% were positive being \u201ciron deficiency\u201d and \u201canaemia of chronic disease\u201d the most frequent causes, 62% and 17%, respectively. Proper treatment was established in 88% of these anaemic patients. Total iron, transferrin, ferritin, folate and vitamin B12 demand decreased substantially after implementation representing a cost reduction of 40% only for these five tests.\nOur system has easily improved patient outcomes, advising on individual clinical cases. We have also noticeably reduced the number of over-requested tests and laboratory costs.<\/jats:p>","DOI":"10.11613\/bm.2021.020702","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T11:20:20Z","timestamp":1618399220000},"page":"250-257","source":"Crossref","is-referenced-by-count":2,"title":["Decision support system through automatic algorithms and electronic request in diagnosis of anaemia for primary care patients"],"prefix":"10.11613","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0339-6704","authenticated-orcid":false,"given":"Enrique","family":"Rodriguez-Borja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macarena","family":"D\u00edaz-Gimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Carratala Calvo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Vinyals-Bellido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Africa","family":"Corchon-Peyrallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ausias","family":"Hervas-Romero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"Pozo-Giraldez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"key20210414071810_r1","first-page":"643","article-title":"Anaemia in the elderly: usefulness of an easy and comprehensive laboratory screen.","volume":"70","author":"Pautas","year":"2012","journal-title":"Ann Biol Clin (Paris)"},{"key":"key20210414071810_r2","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.ccell.2013.09.004","article-title":"Anaemias.","volume":"25","author":"Broadway-Duren","year":"2013","journal-title":"Crit Care Nurs Clin North Am"},{"key":"key20210414071810_r3","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.pop.2016.07.006","article-title":"Anaemia for the Primary Care Physician.","volume":"43","author":"Powell","year":"2016","journal-title":"Prim Care"},{"key":"key20210414071810_r4","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ijlh.12500","article-title":"Laboratory diagnosis of anaemia: are the old and new red cell parameters useful in classification and treatment, how?","volume":"38","author":"Buttarello","year":"2016","journal-title":"Int J Lab Hematol"},{"key":"key20210414071810_r5","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1001\/archinte.1934.00160140099006","article-title":"Anaemia: classification and treatment on the basis of differences in the average volume and hemoglobin content of the red corpuscles.","volume":"54","author":"Wintrobe","year":"1934","journal-title":"Arch Intern Med (Chic)"},{"key":"key20210414071810_r6","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1093\/ajcp\/80.3.322","article-title":"Gilmer PRjr, Gardner FH. Improved classification of anaemias by MCV and RDW.","volume":"80","author":"Bessman","year":"1983","journal-title":"Am J Clin Pathol"},{"key":"key20210414071810_r7","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1056\/NEJM199502023320509","article-title":"Clinical problem-solving. Diagnostic strategy--the shotgun versus the arrow.","volume":"332","author":"Thibault","year":"1995","journal-title":"N Engl J Med"},{"key":"key20210414071810_r8","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1179\/1607845414Y.0000000210","article-title":"Pilot Group of Appropriate Utilization of Laboratory Tests (REDCONLAB) working group. Potential over request in anaemia laboratory tests in primary care in Spain.","volume":"20","author":"Salinas","year":"2015","journal-title":"Hematology."},{"key":"key20210414071810_r9","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1136\/jclinpath-2016-204249","article-title":"Pilot Group of the Appropriate Utilization of Laboratory Tests (REDCONLAB) working group. Primary care requests for anaemia chemistry tests in Spain: potential iron, transferrin and folate over-requesting.","volume":"70","author":"Salinas","year":"2017","journal-title":"J Clin Pathol"},{"key":"key20210414071810_r10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0009-8981(03)00176-1","article-title":"Clinical laboratory consultation: appropriateness to laboratory medicine.","volume":"333","author":"Burke","year":"2003","journal-title":"Clin Chim Acta"},{"key":"key20210414071810_r11","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1093\/clinchem\/45.8.1168","article-title":"The influence of an expert system for test ordering and interpretation on laboratory investigations.","volume":"45","author":"Smith","year":"1999","journal-title":"Clin Chem"},{"key":"key20210414071810_r12","first-page":"S133","article-title":"The generation of narrative interpretations in laboratory medicine: a description of service specific sign out rounds.","volume":"116","author":"Kratz","year":"2001","journal-title":"Am J Clin Pathol"},{"key":"key20210414071810_r13","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0009-8981(02)00032-3","article-title":"Enhanced clinical consulting\u2014moving toward the core competencies of laboratory professionals.","volume":"319","author":"Kratz","year":"2002","journal-title":"Clin Chim Acta"},{"key":"key20210414071810_r14","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1136\/bmj.38979.358032.BE","article-title":"Investigating iron status in microcytic anaemia.","volume":"333","author":"Galloway","year":"2006","journal-title":"BMJ"},{"key":"key20210414071810_r15","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1017\/S1041610211002511","article-title":"Cognitive impairment and vitamin B12: a review.","volume":"24","author":"Moore","year":"2012","journal-title":"Int Psychogeriatr"},{"key":"key20210414071810_r16","first-page":"e100","article-title":"Low clinical utility of folate determinations in primary care setting.","volume":"19","author":"Vinker","year":"2013","journal-title":"Am J Manag Care"},{"key":"key20210414071810_r17","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1515\/cclm-2018-0623","article-title":"Adding clinical utility to the laboratory reports: automation of interpretative comments.","volume":"57","author":"Oosterhuis","year":"2019","journal-title":"Clin Chem Lab Med"},{"key":"key20210414071810_r18","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1258\/acb.2009.009039","article-title":"Reflective testing in the Netherlands: usefulness to improve the diagnostic and therapeutic process in general practice.","volume":"46","author":"Verboeket-van de Venne","year":"2009","journal-title":"Ann Clin Biochem"},{"key":"key20210414071810_r19","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1515\/cclm-2011-0611","article-title":"Reflective testing: adding value to laboratory testing.","volume":"50","author":"Verboeket-van de Venne","year":"2012","journal-title":"Clin Chem Lab Med"},{"key":"key20210414071810_r20","first-page":"125","article-title":"A review on clinical decision support systems in healthcare.","volume":"9","author":"Al-Badareen","year":"2014","journal-title":"J Convergence Inf Technol."},{"key":"key20210414071810_r21","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1038\/s41598-017-18564-8","article-title":"An Application of Machine Learning to Haematological Diagnosis.","volume":"8","author":"Gun\u010dar","year":"2018","journal-title":"Sci Rep"},{"key":"key20210414071810_r22"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/31\/2\/10.11613\/BM.2021.020702\/fullArticle","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T15:23:37Z","timestamp":1626708217000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/31\/2\/10.11613\/BM.2021.020702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6,15]]},"published-print":{"date-parts":[[2021,6,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2021.020702","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6,15]]}}}