AI Article Synopsis
- The study suggests limiting aspartate aminotransferase (AST) testing to cases where alanine aminotransferase (ALT) levels exceed a certain threshold to reduce unnecessary tests.
- With an ALT limit of 35 U/L, inpatient AST testing could be reduced by 51% while still identifying most significant AST elevations.
- In outpatient settings, this approach could cut AST testing by over 65%, potentially saving the US healthcare system around $100 million annually.
Article Abstract
Objectives: Annually, millions of pairs of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) tests are ordered. These enzymes are highly correlated, and ALT is far more specific diagnostically than AST. To reduce AST testing, we suggest measuring AST only when ALT exceeds a predetermined limit.
Methods: We derived the proportions of elevated ASTs that would not be measured based on 15 months of paired inpatient and outpatient ALT and AST data.
Results: For inpatients, a 35 U/L ALT limit for initiating AST testing would reduce AST testing by 51%, missing only 3% and 7.5% of ASTs exceeding 50 U/L and 35 U/L, respectively. In outpatients, AST testing can be reduced by more than 65%, with fewer missed elevated ASTs (0.5% and 2% of the ASTs exceeding 50 U/L and 35 U/L, respectively).
Conclusions: Conservatively, $100 million could be saved annually in the US health care budget by selectively limiting AST testing in just the US outpatient environment.
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| http://dx.doi.org/10.1309/AJCPO47VAWYRIDHG | DOI Listing |
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