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May 10, 2026Annals of Clinical Biochemistry International Journal of Laboratory Medicine

Clinical audit of plasma Methylmalonic acid (MMA) requests following publication of NICE Guidelines on Vitamin B12 deficiency in over 16s

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Authors

GRGary RoulstonKRKathryn RyanDMDerek McKillop

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Overview

Clinical audit evaluates Methylmalonic acid requests following NICE guidelines, indicating improved testing appropriateness.

Key Points

  • To assess the impact of NICE guidelines on the requests for plasma Methylmalonic acid (MMA) testing in Vitamin B12 deficiency cases.
  • Case note review of patients with MMA requests one year before and one year after the NICE NG239 publication.
  • Audit standards were based on NG239 indications for MMA testing.
  • MMA testing increased by 96%, from 57 to 112 requests after NG239.
  • Appropriateness of requests rose from 47% to 79% post-guidelines.
  • Diagnosis of B12 deficiency increased from 16% to 21%, while treatments initiated rose from 14% to 19%.

Cite This Study

Roulston et al. (2026) studied this question.

synapsesocial.com/papers/6a002126c8f74e3340f9bf8ahttps://doi.org/10.1177/00045632261453328
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