ABSTRACT

In this study, our primary aim was to determine the order frequency of antinuclear antibody (ANA) test according to special departments and its results in a university-based hospital. The second aim was to determine the most common cause of ANA test orders and to highlight the importance of "choosing wisely".

The frequency and results of ANA tests ordered for various reasons by clinicians between January 2014 and August 2016 were retrospectively screened by using ANA test code. ANA test was evaluated by indirect immunofluorescence test (IIF) method and reported as+1 positive, +2 positive, +3 positive, +4 positive according to fluorescent grade.

11,407 of ANA test results were taken into consideration. The first five department requiring the most ANA test was neurology, dermatology, rheumatology, pediatric nephrology and hematology. The rate of ANA positivity according to departments including neurology, dermatology, rheumatology and hematology was 14.9%, 15.4%, 32.6% and 14.1%, respectively. It was determined that the rate of +4 positivity of ANA test was the most in patients ordered by rheumatology department. (135/262=%51.5) (p<0.0001). The most reasons for ANA test according to ICD codes were headache, cerebrovascular events and multiple sclerosis for neurology department; urticaria, psoriasis and dermatitis for dermatology; systemic lupus erythematosus (SLE), arthritis, arthralgia, and fibromyalgia for rheumatology; anemia and thrombocytopenia for hematology.

Although neurology was the department that most frequently ordered ANA test in daily clinical practice in our hospital, negativity rate of ANA test was also high in neurology department. The rate of high positivity of ANA test was found by rheumatology department. As a result, in terms of "choosing wisely", when and in which patients ANA test be required must be well known. Awareness must be raised through information sharing on ANA test in order to avoid inappropriate ANA test request.