Serum calcium (S-Ca), the forgotten test: Preliminary results of an appropriateness strategy to detect primary hyperparathyroidism (pHPT)

Salinas, María; López-Garrigós, Maite; Pomares, Francisco; Lugo, Javier; Asencio, Alberto; López-Penabad, Luis; Domínguez, José Ramón Fernández; Leiva‐Salinas, Carlos

doi:10.1016/j.bone.2013.05.011

Cited by 22 publications

(14 citation statements)

References 29 publications

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“…In this scenario, S-calcium may be under requested for two main reasons. First, S-calcium is crucial to detect asymptomatic PHPT 14 . Second S-calcium testing does not usually yield false positive results with a proper sampling technique 21 .…”

Section: Discussionmentioning

confidence: 99%

“…Encouraged by the previous pilot studies in the Valencian Community 12 and all around Spain [13][14][15][16][17][18] a call for data was posted via email. Spanish laboratories willing to participate in the study were invited to fill out an enrollment form and submit their results online.…”

Section: Data Collectionmentioning

confidence: 99%

“…Test requesting inappropriateness is a major issue for a healthcare system 7,8 ; test under requesting results in misdiagnosis, on the other hand, over requesting produces unnecessary expenses, but even physical and psychological patient adverse effects [8][9][10][11] . There is high variability in the request of calcium (S-calcium) and phosphate (S-phosphate), between different regions, and referring physicians [12][13][14][15][16] . In certain areas, S-calcium is under-requested to detect asymptomatic PHPT 14,15 .…”

mentioning

confidence: 99%

“…There is high variability in the request of calcium (S-calcium) and phosphate (S-phosphate), between different regions, and referring physicians [12][13][14][15][16] . In certain areas, S-calcium is under-requested to detect asymptomatic PHPT 14,15 . Currently, through studies investigating regional and geographical differences in test request 12,13,17,18 , we can detect requesting inappropriateness, and deduce the root causes of such potential problem.…”

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confidence: 99%

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Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

et al. 2016

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Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

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“…Regarding leadership, the strategies designed and established in the laboratory to improve clinical decision making can have a great impact in the patient outcome [8]. Laboratory contribution to decision making will further promote communication with the rest of medical specialties.…”

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Knowledge is not enough the Prominence of the Laboratory in Clinical Decision Making Through Creative Imagination, Communication and Leadership

Salinas¹

2013

J Hematol Thrombo Diseases

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Serum Calcium to Phosphorous (Ca/P) Ratio Is a Simple, Inexpensive, and Accurate Tool in the Diagnosis of Primary Hyperparathyroidism

et al. 2017

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Primary hyperparathyroidism (PHPT) diagnosis is challenging and is based on serum calcium (Ca) and parathyroid hormone (PTH). Because serum Ca and phosphorous (P) are inversely related in PHPT, we investigated the diagnostic value of the serum Ca/P ratio in the diagnosis of PHPT. We report a single‐center, case‐controlled, retrospective study including 97 patients with documented PHPT and compared them with those of 96 controls (C). The main outcome measures were: serum PTH, 25‐OH vitamin D, Ca, P, albumin, and creatinine. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the serum Ca/P ratio were calculated. The results were verified using an independent, anonymous set of data extracted from a laboratory database containing over 900 million entries. A total of 35 (36.1%) PHPT patients had normocalcemic PHPT (NCHPT). Ca and PTH were significantly higher in PHPT than in C (p < 0.0001). P was significantly lower in PHPT than in C (p < 0.0001). The Ca/P ratio was significantly higher in PHPT than in C (p < 0.0001). Receiver‐operating characteristic (ROC) curves analyses identified a cutoff of 2.71 (3.5 if Ca and P are expressed in mg/dL) for Ca/P ratio with a sensitivity and specificity of 86% and 87%, respectively (p < 0.0001), confirmed by the independent, big data approach. In conclusion, Ca/P is a valuable tool for the diagnosis of PHPT and is of superior value compared to serum Ca alone, especially in NCPHT. Because Ca/P is simple, inexpensive, and easily accessible worldwide, this ratio is useful for PHPT diagnosis, especially in laboratory/medical settings relying on limited resources, such as low‐income countries. © 2017 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

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Serum calcium (S-Ca), the forgotten test: Preliminary results of an appropriateness strategy to detect primary hyperparathyroidism (pHPT)

Cited by 22 publications

References 29 publications

Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

Knowledge is not enough the Prominence of the Laboratory in Clinical Decision Making Through Creative Imagination, Communication and Leadership

Serum Calcium to Phosphorous (Ca/P) Ratio Is a Simple, Inexpensive, and Accurate Tool in the Diagnosis of Primary Hyperparathyroidism

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