{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:36:57Z","timestamp":1777444617141,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Changes were made to the Australian guidelines for vitamin D testing in November 2014 which restricted the patients who could be tested and reimbursed under the Medical Benefits Schedule. A retrospective study was conducted to assess the impact of the changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 588,021 cases tested for vitamin D over the period of 2014 to 2017 were obtained and the results in 149,808 cases tested before the change in guidelines were compared to 438,213 cases tested afterwards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed an initial fall in requests took place after the introduction of changes, but request numbers had returned to pre-change levels by November 2016. Furthermore, following the intervention, there was a significant reduction in the number of cases of vitamin D deficiency (&lt;50\u2009nmol\/L) detected after November 2014 ( P\u2009&lt;\u20090.001) with odds ratio (OR) calculations showing the strongest effect for the sub-cohort of 0\u201320\u2009nmol\/L (OR\u2009=\u20091.77). For patient vitamin D levels &gt;71\u2009nmol\/L, the pattern of detection inverted with more cases of sufficiency being detected after the intervention than before (OR from 0.84 to 0.48, P &lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The failure to show a sustained reduction in vitamin D testing is a common finding with demand management strategies to limit test requesting. More significant is the failure of the intervention to improve the detection of vitamin D deficiency. These failures highlight the need for better tools to manage test requesting including the use of audit and outcomes measurement to guide future interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004563220987589","type":"journal-article","created":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T03:06:51Z","timestamp":1608952011000},"page":"196-202","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Vitamin D testing: Impact of changes to testing guidelines on detection of patients at risk of vitamin D deficiency"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-2823","authenticated-orcid":false,"given":"Andrew St","family":"John","sequence":"first","affiliation":[{"name":"Drajon Health, Toodyay, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Morris","sequence":"additional","affiliation":[{"name":"IMVS \u2013 Clinical Biochemistry, Adelaide, South Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Richardson","sequence":"additional","affiliation":[{"name":"ANU, Australian Capital Territory, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Lidbury","sequence":"additional","affiliation":[{"name":"ANU, Australian Capital Territory, Canberra, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Ward","sequence":"additional","affiliation":[{"name":"Sullivan & Nicolaides Pathology, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4846-9134","authenticated-orcid":false,"given":"Tony","family":"Badrick","sequence":"additional","affiliation":[{"name":"RCPA Quality Assurance Programs Pty Ltd, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,14]]},"reference":[{"key":"bibr1-0004563220987589","first-page":"46","volume":"89","author":"Kaplan RS","year":"2011","journal-title":"Harv Bus Rev"},{"key":"bibr2-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2017.280214"},{"key":"bibr3-0004563220987589","unstructured":"Interventions to improve the appropriateness and clinical utility of diagnostic investigations. Part of the review of the Medicare Review Taskforce by the Diagnostic Medicine Clinical Committee 2018, https:\/\/www.google.com\/search?q=MBS+Review+Report+from+the+Diagnostic+Medicine+Clinical+Committee+2018&oq=MBS+Review+Report+from+the+Diagnostic+Medicine+Clinical+Committee+2018&aqs=chrome.69i57.13423j0j8&sourceid=chrome&ie=UTF-8 (accessed 2 November 2020)."},{"key":"bibr4-0004563220987589","unstructured":"Changes to Medical Benefits Schedule for Vitamin D Testing, https:\/\/www1.health.gov.au\/internet\/main\/publishing.nsf\/Content\/vitaminDtesting (accessed 2 November 2020)."},{"key":"bibr5-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002955"},{"key":"bibr6-0004563220987589","doi-asserted-by":"publisher","DOI":"10.5694\/mja12.10561"},{"key":"bibr7-0004563220987589","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00497"},{"key":"bibr8-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024797"},{"key":"bibr9-0004563220987589","unstructured":"Royal College of Pathologists of Australia. Use and interpretation of Vitamin D testing, https:\/\/www.rcpa.edu.au\/Library\/College-Policies\/Position-Statements\/Use-and-Interpretation-of-Vitamin-D-Testing (accessed 2 September 2020)."},{"key":"bibr10-0004563220987589","volume-title":"R: a language and environment for statistical computing","author":"Core Team R.","year":"2017"},{"key":"bibr11-0004563220987589","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50619"},{"key":"bibr12-0004563220987589","unstructured":"Australian and New Zealand Bone and Mineral Society. Calcium and Vitamin D position Statement 2017, https:\/\/www.anzbms.org.au\/policies.asp (accessed 2 September 2020)."},{"key":"bibr13-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.123"},{"key":"bibr14-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04320.x"},{"key":"bibr15-0004563220987589","unstructured":"Australian Health Survey: Biomedical Results for Nutrients, 2011-12, https:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/Lookup\/4364.0.55.006Chapter2002011-12 (accessed 2 November 2020)."},{"key":"bibr16-0004563220987589","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2008.056929"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563220987589","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0004563220987589","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563220987589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:24:21Z","timestamp":1777379061000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0004563220987589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,14]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/0004563220987589"],"URL":"https:\/\/doi.org\/10.1177\/0004563220987589","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,14]]}}}