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Morning Report – High Value Care

This morning, Peter Glynn led us on a discussion on high-value care for abnormal LFTs. One study looked at the cost-effectiveness of focused testing (testing that is deliberate, patient-centered) compared with extensive, non-directed testing (testing for all etiologies at once). Some take-aways:

  • When accounting for pre-test probabilities and clinical evaluation, focused testing was more cost-effective, with fewer false positive results
  • Consider hemochromatosis as part of an initial focused testing approach in somebody who is asymptomatic or with nonspecific symptoms (nausea, fatigue, constipation), especially if they do not have a clear alternative explanation for an otherwise unexplained elevation in AST/ALT

https://www.journal-of-hepatology.eu/article/S0168-8278(16)30544-X/fulltext

 

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