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Master Thesis

Elaboration d’un questionnaire de justification des demandes d'ANCA au CHU de Bordeaux en 2014 : impact sur le nombre de prescriptions et leur pertinence

Abstract : Introduction: The anti-neutrophil cytoplasmic antibodies (ANCA) are an efficient tool in the diagnosis of ANCA-associated vasculitis (AAV). AAV are rare and polymorphous diseases, with an uncertain prognosis in spite of therapeutic progress. Then, use of ANCA to screen AAV becomes attractive. However, ANCA are present only in 80 to 90% of granulomatosis with polyangiitis and microscopic polyangiitis, and in 40% of granulomatosis with eosinophilia with polyangiitis. Method: ANCA demands made on 501 persons in the Bordeaux University Hospital in 2013 have been selected randomly. An analysis of all the patient files has been done to state on the relevance of each demand. Then a questionnaire justifying ANCA demands was distributed in the Bordeaux University Hospital in 2014. Results: in 2013, 5943 ANCA tests were carried out in the Bordeaux University Hospital, with 77.8% of negative result. Within the sample of 501 ANCA demands, only 28.7% were relevant. In 2014, the use of a questionnaire justifying ANCA demands enabled a significant 19% decrease of number of demands (i.e. 1132 demands less; p<0.0001). Moreover, the number of ANCA recommendations not justified by a classical visceral disease also decreased significantly (17.1% in 2014 versus 40.7% in 2013). Conclusion: The volume of ANCA demand in the Bordeaux University Hospital was disproportionate with respect to VAA rareness. Only 28.7% of demands were relevant. The use of a questionnaire justifying ANCA demands enabled a significant decrease of number of demands and an improvement of their relevance
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01245180
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, December 16, 2015 - 6:52:39 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:57 PM
Long-term archiving on: : Thursday, March 17, 2016 - 4:50:56 PM

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Pascal Biscay. Elaboration d’un questionnaire de justification des demandes d'ANCA au CHU de Bordeaux en 2014 : impact sur le nombre de prescriptions et leur pertinence. Médecine humaine et pathologie. 2015. ⟨dumas-01245180⟩

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