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Abstract: Poster Presentations |

EFFECT OF HAVING ALPHA-1 ANTITRYPSIN TESTING IN PHYSICIANS LABORATORY WORKUP LISTS IN EARLY DETECTION OF ALPHA 1-ANTITRYPSIN DEFICIENCY FREE TO VIEW

Veronica L. Chastain, MD; Hesham Zaitoun, MD; Nayle Araguez, MD; Jose F. Ramirez, MD; Laurence A. Smolley, MD; Eduardo C. Oliveira, MD; Franck F. Rahaghi, MD*
Author and Funding Information

Cleveland Clinic Florida, Weston, FL


Chest


Chest. 2009;136(4_MeetingAbstracts):88S. doi:10.1378/chest.136.4_MeetingAbstracts.88S-a
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Abstract

PURPOSE:  α1-Antrypsin Deficiency (AATD) is an under-recognized and under-diagnosed condition. Having a laboratory workup list may influence testing for AATD.

METHODS:  In a pulmonary CME conference we conducted a questionnaire survey among the physicians present about their current practices in regard to ordering diagnostic tests in general and specifically their testing for AATD. Physicians were questioned about having a post patient visit lab ordering checkout list.

RESULTS:  The group included 46 physicians, internists (n = 21, 46%), pulmonologists (n = 13, 28%), family physicians (n = 8, 17%) and other medical specialties (n = 3, 6%). A total of 66.7% work in a hospital/clinic mixed practice, 84.4% use paper charts and 46.7% have > 20 years in practice. Of the total, 6.8% reported to test always for AATD on every new patient with chronic obstructive symptoms; 43.2% reported to test occasionally, when there is clinical suspicion; and 50% reported seldom testing. Physicians were divided by having a workup list that included AATD test (27%), having a workup list not including AATD test (27%), and not having a workup list (46%). Of the physicians with a workup list, 83.3% of the group with AATD test on their list reported testing either always or occasionally; versus a 58.3% of the group without the test on their list (not statistically significant), and 39.4% of those without any list at all (Significant difference with the first group: P of 0.0047). Analysis of the frequency of AATD testing by medical specialty showed that 92.3% of pulmonologists are testing either always or occasionally, in contrast with a 31% of the primary care physicians.

CONCLUSION:  Having a laboratory workup list including AATD diagnostic testing increases proactive testing for the disease. Further education for primary care specialties may increase awareness in these groups.

CLINICAL IMPLICATIONS:  Only a minority of AATD patients is recognized and interventions such as adding a workup list or education in primary care specialties may aid in increasing testing.

DISCLOSURE:  Franck Rahaghi, Grant monies (from sources other than industry) Grant form Betty and Stu Hamilton fund for Pulmonary Reseacrh; Grant monies (from industry related sources) Research Grant, Baxter Inc. and CSL Behring; Shareholder None; Employee None; Consultant fee, speaker bureau, advisory committee, etc. Consultant and speaker for CSL Behring and Baxter Inc.; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM


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