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Table 2 Diagnostic characteristics: test utilization, frequency of repeat bone marrow biopsy, and stability and change in diagnosis

From: Diagnostic testing managed by hematopathology specialty and other laboratories: costs and patient diagnostic outcomes

 

Total

Genoptix

Large labs

Other controls

p-value

Study population size

(N = 24,664)

(N = 1,387)

(N = 4,162)

(N = 19,115)

 

Diagnostic flow patterns - Test counts - Post-index fixed 1-year follow-up period (Full population)

Number of bone marrow tests

Mean (SD)

10.92 (11.14)

17.79 (7.08)

3.79 (7.43)

11.97 (11.35)

<0.001

Median

8.00

16.00

1.00

9.00

 

Number of cancer-related tests

Mean (SD)

9.00 (15.91)

5.41 (10.93)

7.54 (14.15)

9.57 (16.52)

<0.001

Median

1.00

0

0

2.00

 

Number of hematology-related tests

Mean (SD)

2.00 (7.36)

2.00 (5.93)

2.00 (7.27)

1.00 (7.47)

<0.001

Median

2.00

2.00

2.00

2.00

 

Number of all laboratory tests (includes all diagnostic tests in claims data)

Mean (SD)

25.48 (25.57)

28.37 (15.01)

17.03 (21.00)

27.11 (26.69)

<0.001

Median

0.00

0.00

0.00

0.00

 

Repeat bone marrow biopsy

Number of bone marrow biopsies

Mean (SD)

1.56 (1.42)

1.13 (0.49)

1.33 (1.04)

1.64 (1.52)

<0.001

Median

1.00

1.00

1.00

1.00

 

Individuals with multiple bone marrow biopsies

n (%)

6,227 (25.25)

133 (9.59)

712 (17.11)

5,382 (28.16)

<0.001

Odds ratio

 

0.307

0.563

  

Confidence interval

(0.255, 0.371)

(0.514, 0.617)

P-value

P < 0.001

P < 0.001

 

Logistic model adjusted for gender, age, region (South), Medicare, initial diagnosis (MM, MDS, CLL, other NHL, MPN, other hematologic cancer/conditions), and baseline Charlson comorbidity score.

Stability of diagnosis

Stable

n (%)

20,333 (90.76)

1,203 (93.84)

3,500 (91.96)

15,630 (90.27)

<0.001

Unstable

n (%)

2,069 (9.24)

79 (6.16)

306 (8.04)

1,684 (9.73)

<0.001

Logistic model of having unstable diagnosis in follow-up

Odds ratio

 

0.866

0.992

  

Confidence interval

(0.68, 1.103 )

(0.867, 1.134)

P-value

P = 0.2427

P = 0.9014

Logistic model adjusted for gender, age, region (Northwest), Medicare, initial diagnosis (MM, CLL, other NHL, MPN, other hematologic cancer/conditions), baseline Charlson comorbidity score, baseline chemotherapy, baseline radiation therapy, baseline inpatient visit, and baseline number of bone marrow-related tests.

Change in diagnosis

No change

n (%)

19,437 (86.76)

1,181 (92.12)

3,380 (88.81)

14,876 (85.92)

<0.001

Change

n (%)

2,965 (13.24)

101 (7.88)

426 (11.19)

2,438 (14.08)

<0.001

Logistic model of diagnosis change in follow-up

Odds ratio

 

0.824

0.939

  

Confidence interval

(0.722, 0.94)

(0.867, 1.018)

P-value

P = 0.0040

P = 0.1256

  

Logistic model adjusted for gender, age2, region (Northwest), initial diagnosis (MM, MDS, other NHL, MPN, other hematologic cancer/conditions), baseline Charlson comorbidity score, baseline chemotherapy, and baseline number of bone marrow-related tests.

  1. Abbreviations: MDS Myelodysplastic syndrome, MPN Myeloproliferative neoplasms, CLL Chronic lymphoid leukemia, MM Multiple myeloma, NHL Non-Hodgkin’s lymphoma, SD Standard deviation.
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BMC Clinical Pathology

ISSN: 1472-6890

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