UK considers Vitamin D tests appropriate for only 4 existing health problems,

Created June 2018

Vitamin D: too much testing and treating?

Clin Med (Lond). 2018 Jun;18(3):196-200. doi: 10.7861/clinmedicine.18-3-196.

* Who needs a vitamin D test -Those with symptoms or those in high risk groups - March 2018 * UK appears to ignore the concept of high-risk groups * which includes dark skin, obese, smokers, cancer, shut-ins, get little sun access, wear concealing clothing, pregnant, Some places disagree with the UK * Japanese need at least 30 ng of Vitamin D, test costs are now reimbursed – Nov 2016 * Mandatory Vitamin D screening for all patients’ – vitamin D conference in Middle East – March 2017 * No vitamin D test needed before supplementing (typically) – April 2014 Many places want to lower the costs by reducing Vitamin D testing     (which will raise long-term total medical costs) * How Alberta Canada restricts Vitamin D testing – May 2016 * France restricts payments for Vitamin D tests – Dec 2015 * Medicare now pays for just one vitamin D test in lifetime * Vitamin D testing in Australia before they shut it down – 42 percent retested – 2013 --- Tests for Vitamin D category listing has items has the following overview/opinion {include}

PDF is available free at Sci-Hub

Woodford HJ1, Barrett S2, Pattman S3.

1 North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK henry.woodford@nhct.nhs.uk.

2 North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

3 North Tyneside General Hospital Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

There is clinical uncertainty as to the testing of serum 25 Hydroxy vitamin D (25[OH]D) concentrations and when to use high-dose supplementation. Data show that there has been a rapid increase in the number of tests performed within the Northumbria Healthcare NHS Foundation Trust over the past 8 years and an increase in high-dose supplementation over the past 5 years. We performed a retrospective analysis of the 25(OH)D test requests over the period from January to -October 2017. A total of 17,405 tests were performed in this time period. The overall average concentration was 57.5 nmol/L and this figure was similar across age groups, although a larger proportion of patients aged over 75 had a concentration <25 nmol/L.

Test requests were classified into 'appropriate', 'inappropriate' and 'uncertain' categories based on current expert opinion.

We found that between 70.4% and 77.5% of tests could be inappropriate , depending on whether the 'uncertain' categories of falls and osteoporosis are considered to be justified. Tiredness, fatigue or exhaustion was the reason for testing in 22.4% of requests. We suggest that a more rational approach to testing, and subsequent treating, could lead to reductions in costs to the healthcare system and patients.

Tags: Europe High Risk Tests