Researchers from Mayo Clinic and the Johns Hopkins University School of Medicine published an article in JAMA Internal Medicine outlining the elimination from clinical practice of a popular test for diagnosing heart attacks. Allan Jaffe, M.D., Consultant and Chair of Mayo Clinic’s Division of Clinical Core Laboratory Services, with a joint appointment in the Division of Cardiovascular Diseases, was one of the authors on the article.
Researchers pointed to steps that institutions should take to phase out creatine kinase-myocardial band testing, or CK-MB, as a diagnostic tool for evaluating patients suspected of having or having had a heart attack. They argued that several peer-reviewed studies strongly suggest that CK-MB "provides no incremental value to patient care, and its elimination can lead to millions of health care dollars saved without adversely affecting patient care."
In the article, researchers outline four steps to phase out the test, including:
- Designing and implementing a hospital-wide education program.
- Partnering with clinical stakeholders to remove CK-MB testing from standardized heart disease routine-testing orders.
- Enlisting information technology and laboratory medicine staff to create and integrate a best practice "alert" that will appear on computerized provider order-entry systems when a CK-MB test is ordered.
- Measuring the use of the test and patient care quality and safety outcomes before and after the intervention.
The researchers said the blueprint is the first step "to finally putting the CK-MB laboratory test to rest" and acknowledged that there will be pushback to getting rid of the test. "[I]n this case, the biggest hurdle has been convincing physicians who have ordered CK-MB for years to change their practice."