Key result
Removing the CK-MB assay from the acute coronary syndrome panel reduced test volume from ~12,000 to ~150 per year, with record review showing it added no essential diagnostic value over troponin.
Why the study?
Does removing CK-MB from the laboratory menu reduce test volume without compromising diagnostic utility?
Observational (n=171)
Does removing CK-MB from the laboratory menu reduce test volume without compromising diagnostic utility?
CK-MB testing does not add value beyond troponin assays and can be safely removed from routine laboratory menus to reduce unnecessary testing.
Answers are grounded in this paper and cite their sources.
May support CK-MB removal from ACS panels to curb unnecessary testing; leaves open prospective validation of safety across settings.
OBJECTIVES: To evaluate the clinical utility of and demand for the creatine kinase (CK)-MB assay. METHODS: We examined the number of CK-MB tests from 2007 through 2013 while we progressively deemphasized their use. We first removed CK-MB from the acute coronary syndrome (ACS) panel and then from the main menu and observed the demand for the test. We also reviewed patient medical records to assess the appropriateness of its use. RESULTS: After removing CK-MB from the ACS panel, the test volume dropped from around 12,000 per year to about 150 per year. In reviewing the records of 171 patients who had CK-MB determination done over a 28-month period, we discovered that CK-MB contributed to the diagnosis in only one patient, although it was not essential. Since removing CK-MB from the laboratory menu, two CK-MB tests were ordered in 4 months, and neither added value. CONCLUSIONS: CK-MB determinations do not add value to information available from the troponin assay and can be safely removed from the laboratory menu.
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Singh et al. (2014) conducted an observational in Acute coronary syndrome (n=171). Creatine kinase-MB (CK-MB) assay was evaluated on Clinical utility and demand for the CK-MB assay. Removing the CK-MB assay from the acute coronary syndrome panel reduced test volume from ~12,000 to ~150 per year, with record review showing it added no essential diagnostic value over troponin.
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