Italian multicentre study for application of a diagnostic algorithm in autoantibody testing for autoimmune rheumatic disease: Conclusive results

Bonaguri, Chiara; Melegari, Alessandra; Ballabio, Andrea; Parmeggiani, Maria; Russo, Annalisa; Battistelli, Luisita; Aloe, Rosalia; Trenti, Tommaso; Lippi, Giuseppe

doi:10.1016/j.autrev.2011.06.006

Cited by 44 publications

(30 citation statements)

References 26 publications

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“…Recently, ANA detection has been confirmed as the first level test for the serology of SARD by an international expert panel [1]. As a matter of fact, classical ANA testing requires the characterization of positive ANA findings by immunoassays for the detection of specific autoAbs to nuclear and cytoplasmic autoantigenic targets in the framework of the recommended two-tier approach [30][31][32]. However, this diagnostic two-step process has proved to be laborious and created constraints in particular for larger laboratories with high throughput [16,30].…”

Section: Discussionmentioning

confidence: 99%

“…As a matter of fact, classical ANA testing requires the characterization of positive ANA findings by immunoassays for the detection of specific autoAbs to nuclear and cytoplasmic autoantigenic targets in the framework of the recommended two-tier approach [30][31][32]. However, this diagnostic two-step process has proved to be laborious and created constraints in particular for larger laboratories with high throughput [16,30]. Several attempts have been made to replace the two-tier testing by one analysis deploying different assay platforms [3,15,30,[33][34][35].…”

Section: Discussionmentioning

confidence: 99%

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Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing

Scholz

Großmann

Knütter

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: For the serological diagnosis of systemic autoimmune rheumatic diseases, a two-tier approach starting with sensitive antinuclear antibody (ANA) detection by indirect immunofluorescence (IIF) on HEp-2 cells followed by characterization of positive findings with different immunoassays is recommended. To overcome drawbacks of this approach, we developed a novel technique allowing the combination of screening and simultaneous confirmatory testing. For the first time, this creates the basis for second generation ANA testing. Methods: ANA and autoantibodies (autoAbs) to doublestranded DNA (dsDNA), CENP-B, SS-A/Ro52, SS-A/Ro60, SS-B/La, RNP-Sm, Sm, and Scl-70 were determined by IIF and enzyme-linked immunosorbent assay (ELISA), respectively, and compared to simultaneous analysis

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing

Scholz

Großmann

Knütter

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Важной задачей стандартизации лабораторной диагностики РЗ является сопоставление и гармони-зация иммунологических тестов с международными и национальными референтными материалами (ат-тестованными стандартными образцами) и мето-дами исследований, базами данных о референтных пределах анализируемых биомаркеров, алгоритма-ми оценки полученных результатов (A) [4][5][6][7][8][9][10].…”

Section: общие рекомендацииunclassified

“…Верхний предел референтного интервала (ВПРИ) антител к гистонам при тестировании сыво- 4. Рекомендуемая частота определения антител к гистонам составляет 1 раз в 6 мес -1 год [10,20].…”

Section: антитела к гистонамunclassified

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Laboratory diagnosis of rheumatic diseases

Александрова¹,

Новиков²,

Насонов³

2015

Lab. sluzh.

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Choosing Wisely in Daily Practice: An Intervention Study on Antinuclear Antibody Testing by Rheumatologists

Lesuis

Hulscher

Piek

et al. 2016

Arthritis Care & Research

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Objective. To assess the effect of a simple intervention on antinuclear antibody (ANA) test overuse by rheumatologists. Methods. This was an explorative, pragmatic, before-and-after, controlled implementation study among rheumatologists working at 3 rheumatology departments in secondary and tertiary care centers in The Netherlands. The intervention was given in all study centers separately and combined education with feedback. Six outcome measures describe the intervention effects: the ANA/new patient ratio (APR), difference with the target APR, percentage of positive ANA tests, percentage of repeated ANA testing, percentage of ANA-associated diseases, and APR variation between rheumatologists. Outcomes were compared between the pre-and postintervention period (both 12 months) using (multilevel) logistic regression or F testing. Results are reported together for centers 1 and 2, and separately for center 3, because ANA tests could not be linked to an individual rheumatologist in center 3. Results. The APR decreased from 0.37 to 0.11 after the intervention in centers 1 and 2 (odds ratio [OR] 0.19, 95% confidence interval [95% CI] 0.17-0.22, P < 0.001) and from 0.45 to 0.30 in center 3 (OR 0.53, 95% CI 0.45-0.62, P < 0.001). The percentage of repeated ANA requests in all centers and the APR variation for centers 1 and 2 decreased significantly. Only in center 3 did the percentage of ANA-associated diseases increase significantly. Conclusion. A simple intervention resulted in a relevant and significant decrease in the numbers of ANA tests requested by rheumatologists, together with an improvement on 3 other outcome measures.

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Italian multicentre study for application of a diagnostic algorithm in autoantibody testing for autoimmune rheumatic disease: Conclusive results

Cited by 44 publications

References 26 publications

Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing

Second generation analysis of antinuclear antibody (ANA) by combination of screening and confirmatory testing

Laboratory diagnosis of rheumatic diseases

Choosing Wisely in Daily Practice: An Intervention Study on Antinuclear Antibody Testing by Rheumatologists

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