Evaluation of Selected Laboratory Components of a Comprehensive Periodic Health Evaluation for Veterans With Spinal Cord Injury and Disorders
Presented in part to the Harvard School of Public Health, August 11, 2004, Boston, MA.
Abstract
Choi H, Binder DS, Oropilla ML, Bernotus EE, Konya D, Nee MA, Tammaro EA, Sabharwal S. Evaluation of selected laboratory components of a comprehensive periodic health evaluation for veterans with spinal cord injury and disorders.
Objective
To evaluate selected laboratory components of a comprehensive periodic health evaluation program for patients with spinal cord injury and disorders (SCI/D).
Design
A retrospective study.
Setting
A Department of Veterans Affairs spinal cord injury center.
Participants
Community-dwelling male veterans with SCI/D (N=350).
Interventions
Not applicable.
Main Outcome Measures
Proportion of laboratory tests that resulted in new diagnoses (diagnostic yield) and proportion of laboratory tests that resulted in changes in management (therapeutic yield).
Results
Although abnormality rates for many routine laboratory tests were high (up to 31.5%), diagnostic and therapeutic yields were low (<1.5%), with the exception of glucose (therapeutic yield, 3.4%) and lipid tests (up to a 4.1% diagnostic and 15.2% therapeutic yield).
Conclusions
Our data revealed that diagnostic and therapeutic yields for many laboratory components of the annual PHE program for veterans with SCI/D were low, consistent with findings in the general ambulatory population. Further data collection, particularly prospective longitudinal data, may help optimize the selection and frequency of laboratory tests performed as part of this program.
aSpinal Cord Injury Service, VA Boston Healthcare System, West Roxbury, MA
bDepartment of Physical Medicine & Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA
cDepartment of Neurosurgery, Brigham & Women’s Hospital, Boston, MA
dDepartment of Physical Medicine & Rehabilitation, Tufts University School of Medicine, Boston, MA
Reprint requests to Howard Choi, MD, MPH, Dept of Rehabilitation Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029.
Supported by the Department of Veterans Affairs/Harvard Medical School Advanced Spinal Cord Injury Fellowship.
The views expressed herein are solely those of the authors and do not necessarily represent the views of any of the affiliated institutions or sponsoring organization.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT