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[Assessment effectiveness of hematological laboratory usage in ambulance of family medicine in Zenica].

AIM AND PURPOSE
Estimation of hematological laboratory effectiveness usage in family medicine, by an assessment of appropriate testing indications and efficiency of testing interpretation.


METHODS
For each patient who was sent to hematological testing, physicians fulfilled the questionnaire. Data gathered was used for computation of diagnostic technology operational characteristics: sensitivity, specificity, predictive values, clinical effectiveness, diagnostic odds ratio and error odds ratio. The data were served for interpretation assessment of testing results. For assessment of indications for hematological testing accuracy setting we used: the number needles (unwanted) testing according to operating diagnosis, number of confirmed operating diagnosis, and number of cases in which testing influence to therapy selection or health improving.


RESULTS
The results have shown sensitivity value of 0.88, specificity value of 0.97, positive predictive value of 0.98, and negative predictive value of 0.85. Effectiveness of diagnostic technology was 0.92, diagnostic odds ratio was 238 and error odds ratio was 0.2. Unwanted haematological testing has noted in 37.3% cases, but pre-test diagnosis had confirmed in 51.8% cases. The testing contribution to improving health status of patients was noted in 57.8% of cases.


CONCLUSION
The results have shown high level of accuracy, effectiveness and diagnostic odds ratio. However, poor assessment of testing indications has shown poor contribution to improving of patient health status.