Читать книгу Laboratory Assessment of Nutritional Status: Bridging Theory & Practice - MARY LITCHFORD - Страница 5

Historically, the physician made all healthcare diagnostic decisions exclusively. In managed care, the multidisciplinary teams work together to make diagnostic recommendations to improve outcomes. As a member of the health care team, it is important to know the clinical value of a test related to its sensitivity, its specificity, its predictive value and the incidence of the disease in the population tested.

Sensitivity refers to the ability of a test to correctly identify individual who truly have a disease. Specificity refers to the ability of a test to correctly identify those individuals who do not have the disease. Sensitivity and specificity do not change with different populations of ill and healthy patients. Predictive value refers to the ability of a screening test result to correctly identify the disease state. The predicative value of the same test can vary considerably with age, gender and geographic location.

As part of the critical thinking matrix of the NCP, it is vital that the nutrition professional consider the following questions when requesting additional laboratory tests.

1) Will the outcome actually change the nutrition plan of care?

If not, then why are you requesting the test be done?

2) Is the test cost-effective?

The cost of lab tests is based on a variety of factors including the volume of individual tests or panels of tests processed at the lab. Lab tests that must be sent to another lab to be processed are considerably more expensive than anything done in house.

3) Is your goal for the patient consistent with their treatment goals and advanced directives?

Be sure to talk with the patient or family to clarify purpose of more testing and how the results might change the plan of care Confirm that additional testing is desired.